Dewanjee M K, Wu S M, De D, Nadkarni R, Gonzalez L, Dewanjee S, Novak S, Perryman R A, Serafini A N, Sfakianakis G N, Duncan R C, Dietrich W D, Ganz W I, Hsu L C
Department of Radiology, University of Miami, School of Medicine, Florida, USA.
ASAIO J. 1996 Sep-Oct;42(5):M661-6. doi: 10.1097/00002480-199609000-00070.
Nitric oxide generation by L-arginine (2 mg/kg/min) infusion during cardiopulmonary bypass (CPB) increases blood flow to all organs and reduces cytokine induced organ damage by reducing the level of marginating neutrophils (Ns). The N-trapping in the oxygenator (OX), arterial filter (AF), cardiotomy reservoir (CR), and N-margination were quantified with indium 111 labeled autologous neutrophils (INN) in nine groups of 40 Yorkshire pigs (30-35 kg). Cardiopulmonary bypass (180 min or 90 min CPB, 90 min reperfusion) was carried out at 2.5-3.5 L/min and at two temperatures (18 degrees C, 28 degrees C). The INN (650-780 microCi) was administered intravenously 15 mins before CPB. All pigs received heparin systemically (activated coagulation time > 400 secs); CPB was instituted with a roller pump, OX (Univox 1.8 m2), AF (0.25 m2), and CR (BCR-3500, Bentley Lab, Irvine, CA). The INN distribution in the device (OX, AF, CR) and organs was imaged with a gamma camera and measured with an ion chamber and a gamma counter. The LA infusion decreased N-trapping, estimated as the percent of injected INN (mean +/- standard deviation), in OX from control (2.7 +/- 2.02)% to (0.94 +/- 0.29)%, and margination in lung from control (48 +/- 4)% to minimal levels (23 +/- 2)% (p < 0.01). In the CPB reperfusion group, a beneficial effect was observed at LA low dose and toxicity of higher N-margination at 15 mg/ kg/min. Neither CPB temperature nor Leumedin affected N-margination significantly.
在体外循环（CPB）期间输注L-精氨酸（2毫克/千克/分钟）产生的一氧化氮可增加所有器官的血流量，并通过降低边缘性中性粒细胞（Ns）水平来减少细胞因子诱导的器官损伤。使用铟111标记的自体中性粒细胞（INN）对九组40头约克夏猪（30 - 35千克）的体外循环器（OX）、动脉滤器（AF）、心内直视手术储血器（CR）中的氮捕获以及氮边缘化进行了量化。体外循环（180分钟或90分钟CPB，90分钟再灌注）在2.5 - 3.5升/分钟的流量和两个温度（18摄氏度、28摄氏度）下进行。在CPB前15分钟静脉注射INN（650 - 780微居里）。所有猪均全身接受肝素治疗（活化凝血时间>400秒）；使用滚压泵、OX（Univox 1.8平方米）、AF（0.25平方米）和CR（BCR - 3500，Bentley实验室，加利福尼亚州欧文市）建立体外循环。使用伽马相机对装置（OX、AF、CR）和器官中的INN分布进行成像，并使用电离室和伽马计数器进行测量。L-精氨酸输注降低了氮捕获，以注入INN的百分比估计（平均值±标准差），在体外循环器中从对照组的（2.7±2.02）%降至（0.94±0.29）%，在肺中的边缘化从对照组的（48±4）%降至最低水平（23±2）%（p<0.01）。在CPB再灌注组中，在低剂量L-精氨酸时观察到有益效果，而在15毫克/千克/分钟时更高的氮边缘化具有毒性。CPB温度和Leumedin均未显著影响氮边缘化。
