Protection of Postoperative Lung Function by Cardiopulmonary Bypass Pulmonary Artery Perfusion Fluid_West China Medical Journal

Authors：

ZHAO Yu ¹ , KANG Zhongkui ²

1. Department of Anesthesia, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P. R. China; 2. Department of Anesthesia, Second People’s Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;

Corresponding?author：

Keywords：

肺動脈灌注; 肺保護; 體外循環

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目的　探討體外循環（CPB）期間行肺動脈灌注液對術后肺功能的保護作用。方法　2007年1月－2011年4月30例在CPB下行單純二尖瓣人工機械瓣置換術患者，隨機分成肺保護組和對照組各15例，肺保護組患者CPB期間經肺動脈灌注低溫肺保護液，對照組患者CPB期間未經肺動脈灌注低溫肺保護液。監測兩組患者在麻醉誘導后、阻斷主動脈l0 min及開放主動脈l0 min，2 、12、24 h各時間點的呼吸指數（RI）、氧合指數（OI）、白介素6（IL-6）、腫瘤壞死因子α（TNF-α）及術前、術后肺動脈壓力（PAPm）、靜態肺順應性（CLS）、氣道阻力（AR）變化，并比較術后ICU監護時間、術后呼吸機輔助時間、住院天數及有無術后并發癥等。結果　兩組IL-6、TNF-α、RI、OI、PAPm、AR、CLS比較差異均有統計學意義（P＜0.05）。但術后ICU監護時間及住院時間比較差異均無統計學意義（P＞0.05）。結論　CPB期間行肺動脈灌注對術后肺功能具有保護作用。

Citation： ZHAO Yu,KANG Zhongkui. Protection of Postoperative Lung Function by Cardiopulmonary Bypass Pulmonary Artery Perfusion Fluid. West China Medical Journal, 2012, 27(3): 347-349. doi: Copy

1.	Ng CS, Wan S, Yim AP, et al. Pulmonary dysfunction after cardiac surgery[J]. Chest, 2002, 121(4): 1269-1277.
2.	Paparella D, Yan TM, Young E. Cardiopulmonary bypass induced inflammation pathophyaiology and trestment. An update[J]. Eur J Cardiothoacsurg, 2002, 21(2): 232-244.
3.	林柏松, 張秀和, 張柏民, 等. 肺動脈灌注肺保護液對體外循環相關性炎癥反應影響的實驗研究[J]. 中國實驗診斷學, 2010, 14(2): 1007-4287.
4.	魏波, 劉迎龍, 于存濤, 等. 肺動脈灌注低溫肺保護液減輕體外循環肺內炎性反應[J]. 中華胸心血管外科雜志, 2004, 20(1): 4-6.
5.	Asimakopoulos G, Smith P, Ratnatunga C, et al. Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass[J]. Ann Thomc Surg, 1999, 68(3): 1107-1115.
6.	Scholz M, Simon A, Marheis G, et al. leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery[J]. Inflamm Res, 2002, 51(7): 363-368.
7.	Sutton SW, Patel AN, Chase VA, et al. Clinical benefits of continuous leukocyte filtration during cardiopulmonary bypass in patients undergoing valvular repair or replacement[J]. Perfusion, 2005, 20(1): 21-29.
8.	Clark SC. Lung injury afer cardiopulmonary bypass[J]. Perfusion, 2006, 21(4): 225-228.
9.	Taggart DR, EI-Fiky M, Carter R, et al. Respiratory dysfunction after uncomplicated cardiopulmonary bypass[J]. AnnThomc Surg, 1993, 56(5): 1123-1128.
10.	Türköz R, Yörüko?lu K, Akcay A, et al. The effect of pentoxifylline on the lung during cardiopulmonary bypass[J]. EurJ Cardiothorac Surg, 1996, 10(5): 339-346.
11.	Serraf A, Aznag H, Baudet B, et al. Pulmonary vascular endothelial growth factor and nitric oxide interaction during total cardiopulmonary bypass in neonatal pigs[J]. Thorac Cardiovasc Surg, 2003, 125(5): 1050-1057.
12.	Wan S, Desmet JM, Barvais L, et al. Myocardium is amajor source of proinflammatory cytokines in patient undergoing cardiopulmonary bypass[J]. Thorac Cardiovasc Surg, 1996, 112(3): 806-811.
13.	Liebold A, Keyl L, Bimbaum DE, et al. The heart produces, but lungs consume proinflammatory cytokines following cardiopulmonary bypass[J]. Cardiothorac Surg, 1999, 15(3): 340-345.
14.	Camey DE, Lntz CJ, Picone AL, et al. Soluble tumor necrosis factor receptor prevents post-pump syndrome[J]. J Surg Res, 1999, 83(2): 113-121.
15.	Wei B, Liu YL. Lung perfusion with protective solution relieves lung injury in corrections of tetralogy of fallet[J]. Ann Thorac Surg, 2004, 77(3): 918-924.
16.	Liu YL, Wang Q. Pulmonary artery perfusion with protective solution reduces lung injury after cardiopulmonary bypass[J]. Ann Thorac Surg, 2000, 69(5): 1402-1407.

1. 　Ng CS, Wan S, Yim AP, et al. Pulmonary dysfunction after cardiac surgery[J]. Chest, 2002, 121(4): 1269-1277.
2. 　Paparella D, Yan TM, Young E. Cardiopulmonary bypass induced inflammation pathophyaiology and trestment. An update[J]. Eur J Cardiothoacsurg, 2002, 21(2): 232-244.
3. 　林柏松, 張秀和, 張柏民, 等. 肺動脈灌注肺保護液對體外循環相關性炎癥反應影響的實驗研究[J]. 中國實驗診斷學, 2010, 14(2): 1007-4287.
4. 　魏波, 劉迎龍, 于存濤, 等. 肺動脈灌注低溫肺保護液減輕體外循環肺內炎性反應[J]. 中華胸心血管外科雜志, 2004, 20(1): 4-6.
5. 　Asimakopoulos G, Smith P, Ratnatunga C, et al. Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass[J]. Ann Thomc Surg, 1999, 68(3): 1107-1115.
6. 　Scholz M, Simon A, Marheis G, et al. leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery[J]. Inflamm Res, 2002, 51(7): 363-368.
7. 　Sutton SW, Patel AN, Chase VA, et al. Clinical benefits of continuous leukocyte filtration during cardiopulmonary bypass in patients undergoing valvular repair or replacement[J]. Perfusion, 2005, 20(1): 21-29.
8. 　Clark SC. Lung injury afer cardiopulmonary bypass[J]. Perfusion, 2006, 21(4): 225-228.
9. 　Taggart DR, EI-Fiky M, Carter R, et al. Respiratory dysfunction after uncomplicated cardiopulmonary bypass[J]. AnnThomc Surg, 1993, 56(5): 1123-1128.
10. 　Türköz R, Yörüko?lu K, Akcay A, et al. The effect of pentoxifylline on the lung during cardiopulmonary bypass[J]. EurJ Cardiothorac Surg, 1996, 10(5): 339-346.
11. 　Serraf A, Aznag H, Baudet B, et al. Pulmonary vascular endothelial growth factor and nitric oxide interaction during total cardiopulmonary bypass in neonatal pigs[J]. Thorac Cardiovasc Surg, 2003, 125(5): 1050-1057.
12. 　Wan S, Desmet JM, Barvais L, et al. Myocardium is amajor source of proinflammatory cytokines in patient undergoing cardiopulmonary bypass[J]. Thorac Cardiovasc Surg, 1996, 112(3): 806-811.
13. 　Liebold A, Keyl L, Bimbaum DE, et al. The heart produces, but lungs consume proinflammatory cytokines following cardiopulmonary bypass[J]. Cardiothorac Surg, 1999, 15(3): 340-345.
14. 　Camey DE, Lntz CJ, Picone AL, et al. Soluble tumor necrosis factor receptor prevents post-pump syndrome[J]. J Surg Res, 1999, 83(2): 113-121.
15. 　Wei B, Liu YL. Lung perfusion with protective solution relieves lung injury in corrections of tetralogy of fallet[J]. Ann Thorac Surg, 2004, 77(3): 918-924.
16. 　Liu YL, Wang Q. Pulmonary artery perfusion with protective solution reduces lung injury after cardiopulmonary bypass[J]. Ann Thorac Surg, 2000, 69(5): 1402-1407.

West China Medical Journal

Protection of Postoperative Lung Function by Cardiopulmonary Bypass Pulmonary Artery Perfusion Fluid

Abstract Full text Figures/Tables Video References Cited by

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