Document Detail


High oxygen concentration exacerbates cardiopulmonary bypass-induced lung injury.
MedLine Citation:
PMID:  11052431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the effect of ventilation with 100% oxygen on lung injury associated with surgery involving cardiopulmonary bypass (CPB). DESIGN: A prospective randomized study. SETTING: University hospital. PARTICIPANTS: Thirty patients undergoing coronary artery bypass graft surgery with CPB. INTERVENTIONS: Patients were randomized to receive 100% oxygen (Oxygen group) or 50% oxygen (Air group) throughout surgery. During CPB, patients' lungs in the Air group were flushed with air and in the Oxygen group with 100% oxygen. MEASUREMENTS AND MAIN RESULTS: Lung injury was evaluated by arterial oxygen tension-inspired oxygen concentration (PaO2-FIO2) ratio and cytokine levels (tumor necrosis factor-alpha and interleukin-8) in blood and bronchoalveolar lavage fluid measured before and after CPB. The lowest PaO2-FIO2 value was observed after 40 minutes following the completion of CPB in both groups. PaO2-FIO2 values 6 hours after CPB were not different from baseline in the Air group but remained lower (359+/-63 mmHg and 298+/-78 mmHg; p = 0.013) in the Oxygen group. Blood cytokine levels rose during surgery in both groups. Bronchoalveolar lavage levels of interleukin-8 did not change, whereas tumor necrosis factor-alpha increased only in the Oxygen group (p = 0.035). CONCLUSIONS: A significant decrease of oxygenation was observed in the early post-CPB period in both groups of patients, with delay in recovery in patients treated with 100% oxygen. A larger increase of the proinflammatory cytokines was found in patients treated with 100% oxygen. High oxygen concentrations during surgery with CPB should be used only when specifically required.
Authors:
R Pizov; Y G Weiss; A Oppenheim-Eden; H Glickman; S Goodman; Y Koganov; V Barak; G Merin; M R Kramer
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  14     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-02-07     Completed Date:  2001-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  519-23     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and CCM, Hadassah Medical Center, Jerusalem, Israel.
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MeSH Terms
Descriptor/Qualifier:
Bronchoalveolar Lavage Fluid / immunology
Cardiopulmonary Bypass / adverse effects*
Humans
Interleukin-8 / biosynthesis
Oxygen / toxicity*
Prospective Studies
Respiratory Distress Syndrome, Adult / etiology*
Tumor Necrosis Factor-alpha / biosynthesis
Chemical
Reg. No./Substance:
0/Interleukin-8; 0/Tumor Necrosis Factor-alpha; 7782-44-7/Oxygen

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


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