Document Detail

Controlled lung reperfusion to reduce pulmonary ischaemia/reperfusion injury after cardiopulmonary bypass in a porcine model.
MedLine Citation:
PMID:  25142069     Owner:  NLM     Status:  Publisher    
OBJECTIVES: Ischaemia/reperfusion (I/R) injury of the lungs contributes to pulmonary dysfunction after cardiac surgery with cardiopulmonary bypass (CPB), leading to increased morbidity and mortality of patients. This study investigated the value of controlled lung reperfusion strategies on lung ischemia-reperfusion injury in a porcine CPB model.
METHODS: Pigs were subjected to routine CPB for 120 min with 60 min of blood cardioplegic cardiac arrest (CCA). Following CCA, the uncontrolled reperfusion (UR, n = 6) group was conventionally weaned from CPB. Two groups underwent controlled lung reperfusion strategies (CR group: controlled reperfusion conditions, n = 6; MR group: controlled reperfusion conditions and modified reperfusate, n = 6) via the pulmonary artery before CPB weaning. Sham-operated pigs (n = 7) served as controls. Animals were followed up until 4 h after CPB. Pulmonary function, haemodynamics, markers of inflammation, endothelial injury and oxidative stress as well as morphological lung alterations were analysed.
RESULTS: CPB (UR group) induced deterioration of pulmonary function (lung mechanics, oxygenation index and lung oedema). Also, controlled lung reperfusion groups (CR and MR) presented with pulmonary dysfunction after CPB. However, compared with UR, controlled lung reperfusion strategies (CR and MR) improved lung mechanics and reduced markers of oxidative stress, but without alteration of haemodynamics, oxygenation, inflammation, endothelial injury and lung morphology. Both controlled reperfusion groups were similar without relevant differences.
CONCLUSION: Controlled lung reperfusion strategies attenuated a decrease in lung mechanics and an increase in oxidative stress, indicating an influence on CPB-related pulmonary injury. However, they failed to avoid completely CPB-related lung injury, implying the need for additional strategies given the multifactorial pathophysiology of postoperative pulmonary dysfunction.
Ingo Slottosch; Oliver Liakopoulos; Elmar Kuhn; Antje Deppe; Alberto Lopez-Pastorini; David Schwarz; Klaus Neef; Yeong-Hoon Choi; Kristina Jung; Christian Mühlfeld; Thorsten Wahlers
Related Documents :
3284419 - Continuous-wave doppler of vertebral arteries in noninvasive diagnosis and management o...
8774399 - Transluminal angioplasty for arteriosclerotic disease of the distal vertebral and basil...
2072169 - Microvascular anatomy of foramen caecum medullae oblongatae.
20679919 - In vivo retrieval of a trapped merci embolectomy device: technical case report.
2181339 - Wallenberg's syndrome following neck manipulation.
20150549 - Recanalization of vertebral artery dissection.
21967889 - Carotid stent fracture and restenosis management.
10808149 - Invasive and non-invasive determinants of pulmonary hypertension in patients with chron...
1155019 - Morphological study on the thebesian veins of the right cavities of the heart in the dog.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-20
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  -     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Prospective, randomized, double-blinded trial of bone marrow cell transplantation combined with coro...
Next Document:  Characteristics of chromium-allergic dermatitis patients prior to regulatory intervention for chromi...