Zhang Renteng, Wang Zengwei, Wang Huishan, Song Hengchang, Zhang Nanbin, Fang Minhua
Department of Cardiovascular Surgery, Shenyang Northern Hospital, Shenyang, China.
Heart Surg Forum. 2011 Feb;14(1):E18-21. doi: 10.1532/HSF98.20101031.
Reducing lung injury during cardiopulmonary bypass (CPB) is important for patients' recovery. The present study was designed to research convenient and effective pulmonary artery perfusion mode during CPB in an animal model.
Twelve healthy mongrel dogs were randomly divided into 2 groups: a control group and a perfusion group designed to simulate clinical CPB-induced lung injury. During CPB, pulmonary artery perfusion with modified low-potassium dextran (LPD) solution was performed immediately after the initiation of ischemia and before reperfusion for 3 to 4 minutes each time, with pressure maintained at 15 to 20 mmHg; animals in the control group were not perfused. After pulmonary reperfusion, the changes in pulmonary function and tissue biochemical data were determined.
Compared with the control group, lung compliance, oxygenation, and vascular resistance after reperfusion were significantly improved in the perfusion group. The malonaldehyde concentration, neutrophil sequestration ratio, and tissue water content also decreased significantly in the perfusion group.
The pulmonary artery perfusion mode used in this experiment could relieve CPB-induced lung injury effectively. Improving cellular tolerance to hypoxia and decreasing inflammatory reaction may be the important mechanisms. Moreover, this mode is convenient and does not interfere with the intended operations, which is promising for clinical use.
减轻体外循环（CPB）期间的肺损伤对患者恢复至关重要。本研究旨在在动物模型中探究CPB期间便捷有效的肺动脉灌注模式。
将12只健康杂种犬随机分为2组：对照组和旨在模拟临床CPB诱导肺损伤的灌注组。在CPB期间，每次缺血开始后和再灌注前立即用改良低钾右旋糖酐（LPD）溶液进行肺动脉灌注3至4分钟，压力维持在15至20 mmHg；对照组动物不进行灌注。肺再灌注后，测定肺功能和组织生化数据的变化。
与对照组相比，灌注组再灌注后的肺顺应性、氧合和血管阻力显著改善。灌注组的丙二醛浓度、中性粒细胞滞留率和组织含水量也显著降低。
本实验采用的肺动脉灌注模式可有效减轻CPB诱导的肺损伤。提高细胞对缺氧的耐受性和减少炎症反应可能是重要机制。此外，该模式便捷且不干扰预期操作，具有临床应用前景。
