Document Detail


Effect of L-arginine or nitroglycerine during deep hypothermic circulatory arrest in neonatal lambs.
MedLine Citation:
PMID:  12537216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The role of nitric oxide (NO) in ischemia-reperfusion injury remains controversial. This study evaluated the effects of L-arginine (NO precursor) or nitroglycerine (NO donor) on cardiac and lung function after deep hypothermic circulatory arrest in neonatal lambs. METHOD: Three groups of anesthetized lambs underwent cardiopulmonary bypass, deep hypothermic circulatory arrest (120 minutes at 18 degrees C), and rewarming (40 minutes). During reperfusion, L-arginine (5 mg/kg per minute), nitroglycerine (2 microg/kg per minute), or saline (control group) was infused for 100 minutes. All animals were separated from cardiopulmonary bypass and observed for 3 additional hours. Preload recruitable stroke work, cardiac index, pulmonary vascular resistance, alveolar-arterial oxygen difference, and lung compliance plasma nitrate/nitrite levels (NO metabolites) were measured before and after cardiopulmonary bypass. Malondialdehyde in heart tissue and lung tissue was measured 3 hours after cardiopulmonary bypass. RESULTS: Recovery of preload recruitable stroke work and cardiac index were significantly higher in the L-arginine and nitroglycerine groups than in the control group (p < 0.05). Pulmonary vascular resistance was significantly lower in the L-arginine and nitroglycerine groups than in the control group (p < 0.05). Levels of NO metabolites and issue malondialdehyde did not differ among groups. CONCLUSIONS: L-arginine and nitroglycerine improved recovery of left ventricular function and reduced pulmonary vascular resistance after deep hypothermic circulatory arrest. The mechanism of beneficial action could involve increased NO levels, but we did not find higher levels of NO metabolites compared with controls. Tissue malondialdehyde levels were not affected by L-arginine or nitroglycerine. These results show that, at these dosage levels, provision of substrate for NO production or provision of an NO donor were beneficial to the recovery of myocardial and pulmonary vascular function.
Authors:
Shinichi Hatsuoka; Takahiko Sakamoto; Ulrich A Stock; Mitsugi Nagashima; John E Mayer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-22     Completed Date:  2003-02-13     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-203; discussion 203     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Arginine / pharmacology*
Heart Arrest, Induced*
Hypothermia, Induced*
Lung Compliance / drug effects
Malondialdehyde / analysis
Nitrates / blood
Nitrites / blood
Nitroglycerin / pharmacology*
Pulmonary Circulation / drug effects
Sheep
Stroke Volume / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Nitrates; 0/Nitrites; 542-78-9/Malondialdehyde; 55-63-0/Nitroglycerin; 74-79-3/Arginine

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


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