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The effect of deep hypothermia on the human pulmonary circulation.
MedLine Citation:
PMID:  24556256     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: Acute rises in pulmonary artery pressures following complex cardiac surgery are associated with high morbidity and mortality. We hypothesised that periods of deep hypothermia predispose to elevated pulmonary pressures upon rewarming. We investigated the effect of this hypothermic preconditioning on isolated human pulmonary arteries and isolated perfused lungs.
METHODS: Isometric tension was measured in human pulmonary artery rings (n=24). We assessed the constriction and dilation of these arteries at 37°C and 17°C. Isolated perfused human lung models consisted of lobes ventilated via a bronchial cannula and perfused with Krebs via a pulmonary artery cannula. Bronchial and pulmonary artery pressures were recorded. We investigated the effect of temperature using a heat exchanger.
RESULTS: Rewarming from 17°C to 37°C caused a 1.3 fold increase in resting tension (p<0.05). Arteries constricted 8.6 times greater to 30nM KCl, constricted 17 times greater to 1nM Endothelin-1 and dilated 30.3 times greater to 100μM SNP at 37°C than at 17°C (p<0.005). No difference was observed in the responses of arteries originally maintained at 37°C compared to those arteries maintained at 17°C and rewarmed to 37°C. Hypothermia blunted the increase in pulmonary artery pressures to stimulants such as potassium chloride as well as to H-R but did not precondition arteries to higher pulmonary artery pressures upon re-warming.
CONCLUSIONS: Deep hypothermia reduces the responsiveness of human pulmonary arteries but does not, however, precondition an exaggerated response to vasoactive agents upon re-warming.
Priyadharshanan Ariyaratnam; Mahmoud Loubani; Alexander R J Cale; Mubarak Chaudhry; Michael E Cowen; Martin A Jarvis; Steven Griffin; Alyn H Morice
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Publication Detail:
Type:  Journal Article     Date:  2014-01-13
Journal Detail:
Title:  Journal of thermal biology     Volume:  40     ISSN:  0306-4565     ISO Abbreviation:  J. Therm. Biol.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-02-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7600115     Medline TA:  J Therm Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  20-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 Elsevier Ltd. All rights reserved.
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