Study of the mechanism of pulmonary protection strategy on pulmonary injury with deep hypothermia low flow

X. Yewei, D. Liya, Z. Jinghao, Z. Rufang, S. Li

Department of Cardiovascular and Thoracic Surgery, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, China. leisure_ya@126.com

 

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• Cardiology

BACKGROUND: The influence of deep hypothermia low-flow (DHLF) perfusion on inflammatory response of pulmonary injury in mammals undergoing the cardiopulmonary bypass (CPB) remains unknown.

OBJECTIVES: This study was conducted to determine the feasibility and mechanism of pulmonary protection strategy on preventing pulmonary function from ischemia reperfusion injury with piglet model.

MATERIALS AND METHODS: Eighteen piglets were divided randomly into three groups: control group with DHLF; continuous perfusion of pulmonary arteries (CPP) with DHLF group (CPP group) and partial liquid ventilation (PLV) with perfluorocarbon (PFC) after CPP with DHLF group (PLV group). Pulmonary ventilation functions in arterial blood samples were measured at pre-CPB, 0h, 1h and 2h until the end of CPB. Inflammatory factor TNF-alpha, IL-8 and IL-6, adherence factor ICAM-1 were also measured.

RESULTS: After CPB, PaO2 increased but PaCO2 decreased significantly in the PLV group compared with control group. Pulmonary gas exchange in PLV group also improved more significantly than that in CPP group. The expression of TNF-alpha, IL-8 and IL-6 in serum increased more significantly in PVL group after CPB 1h than control group. The extent of lung injury was decreased significantly in PLV than that in CPP group and control group.

CONCLUSIONS: CPP had a protective effect in lung ischemia reperfusion injury during DHLF, and the role of protection lung with maintaining PLV after CPP during DHLF is better than that of single CPP perfusion.

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