Pulmonary artery perfusion with hypothermic solution reduces the lung injury of the children with pulmonary hypertension after cardiopulmonary bypass
WANG Qiang, LIU Yinglong, LONG Cun, et al. Fuwai Hospital, CAMS & PUMC, Beijing 100037, China
Objective To evaluate portective effects of pulmonary artery perfusion with hypothermic solution on the lung tissue and functions of the children with pulmonary hypertension after cardiopulmonary bypass (CPB). Methods 34 young children with congenital heart disease and pulmonary hypertension were divided into the control group ( n =23) and the protective group ( n =11). The basic parameters (age, weight, data of catheterization and other assistant examination )were not different between two groups. The routine techniques were performed in the patients of control group and the pulmonary artery were infused with 4℃ protective solution during CPB in the protective group patients. Patients' hemodynamics and lung functions were mornitored, white blood cell counts and plasma MDA were measured, and lung biopsies were also made. Results Pulmonary vascular resistance decreased significantly in the protective group than in the control group at 6, 12,24, 36 and 48 hours after cardiopulmonary bypass (731±146, 649±104, 683±113, 583±96, 492±40, 517±70,and 510±93) dynes s cm 5 versus (814±86, 1?105±118, 1?006±132, 873±100, 844±101,830±85, and 826±127) dynes s cm 5 respectivelly (all P 0.05). Airway resistance(AR) increased in the control group after CPB, but didn′t change in the protective group. AR was lower in the protective group than in the control group at 6, 12,and 24 hrs after CPB(all P 0.01). Oxygen index was higher in the protective group than in the control group and the difference was significant at 36 hours after CPB( P 0.05). The time of mechanical ventilation was shorter in the protective group when compared with the control group ( P 0.01); Neutrophil ratio of vein and artery was 1.12 after CPB indicating neutrophil accumulation in the control group ( P 0.01); MDA was lower in the protective group than in the control group at 24, 36, 48, and 72 hours after CPB (all P 0.01 or 0.05). Tissue examination showed that intraalveolar edema, capillary hyperemia, leukocytes accumulated, and mitochondria swelling in the control group, whereas no such changes occurred in the protective group. Conclusion Pulmonary artery perfusion with hypothermic solution could ameliorate lung function after cardiopulmonary bypass.
【CateGory Index】： R654.1