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Continuous perfusion of pulmonary arteries during total cardiopulmonary bypass favorably affects levels of circulating adhesion molecules and lung function.
J Thorac Cardiovasc Surg. 2001 Aug; 122(2):242-8.JT

Abstract

OBJECTIVES

Lung injury is a serious complication of cardiopulmonary bypass in infants with congenital heart disease and pulmonary hypertension. Cessation of blood flow in the pulmonary arteries during cardiopulmonary bypass is known to provoke lung dysfunction. We assessed the effect of continuous pulmonary perfusion on circulating adhesion molecules and on lung function.

METHODS

Fourteen infants with congenital heart disease and pulmonary hypertension were enrolled in the study. During total cardiopulmonary bypass, 8 patients underwent continuous perfusion of the pulmonary arteries (perfusion group), and the remaining 6 patients did not (control group). Plasma levels of circulating intercellular adhesion molecule 1, soluble granule membrane protein 140, and sialyl Lewis(x) and PaO (2)/fraction of inspired oxygen ratios were measured before commencement and serially for 24 hours after termination of bypass.

RESULTS

Plasma levels of circulating intercellular adhesion molecule 1 decreased significantly at the termination of bypass in both groups but returned to prebypass levels immediately in the control group, whereas in the perfusion group the values remained significantly less than those before bypass. Plasma levels of soluble granule membrane protein 140 in the control group were significantly higher at 6 and 12 hours after bypass than levels before bypass, whereas in the perfusion group the values remained at the prebypass level throughout the postbypass period. Trends of plasma levels of sialyl Lewis(x) were alike in both groups. PaO (2)/fraction of inspired oxygen ratios in the control group decreased significantly from 6 hours after bypass, whereas values in the perfusion group remained at the prebypass value throughout the postbypass period.

CONCLUSIONS

This study suggests that in infants having congenital heart disease and pulmonary hypertension, continuous pulmonary perfusion during total cardiopulmonary bypass minimizes ischemic insult and neutrophil-endothelial interaction mediated by adhesion molecules in the pulmonary microvessels.

Authors+Show Affiliations

Division of Cardiovascular Surgery, Tokyo Metropolitan Children's Hospital, School of Medicine, Kyorin University, Tokyo, Japan. suzukimd@blue.ocn.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11479496

Citation

Suzuki, T, et al. "Continuous Perfusion of Pulmonary Arteries During Total Cardiopulmonary Bypass Favorably Affects Levels of Circulating Adhesion Molecules and Lung Function." The Journal of Thoracic and Cardiovascular Surgery, vol. 122, no. 2, 2001, pp. 242-8.
Suzuki T, Ito T, Kashima I, et al. Continuous perfusion of pulmonary arteries during total cardiopulmonary bypass favorably affects levels of circulating adhesion molecules and lung function. J Thorac Cardiovasc Surg. 2001;122(2):242-8.
Suzuki, T., Ito, T., Kashima, I., Teruya, K., & Fukuda, T. (2001). Continuous perfusion of pulmonary arteries during total cardiopulmonary bypass favorably affects levels of circulating adhesion molecules and lung function. The Journal of Thoracic and Cardiovascular Surgery, 122(2), 242-8.
Suzuki T, et al. Continuous Perfusion of Pulmonary Arteries During Total Cardiopulmonary Bypass Favorably Affects Levels of Circulating Adhesion Molecules and Lung Function. J Thorac Cardiovasc Surg. 2001;122(2):242-8. PubMed PMID: 11479496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous perfusion of pulmonary arteries during total cardiopulmonary bypass favorably affects levels of circulating adhesion molecules and lung function. AU - Suzuki,T, AU - Ito,T, AU - Kashima,I, AU - Teruya,K, AU - Fukuda,T, PY - 2001/8/2/pubmed PY - 2001/9/14/medline PY - 2001/8/2/entrez SP - 242 EP - 8 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 122 IS - 2 N2 - OBJECTIVES: Lung injury is a serious complication of cardiopulmonary bypass in infants with congenital heart disease and pulmonary hypertension. Cessation of blood flow in the pulmonary arteries during cardiopulmonary bypass is known to provoke lung dysfunction. We assessed the effect of continuous pulmonary perfusion on circulating adhesion molecules and on lung function. METHODS: Fourteen infants with congenital heart disease and pulmonary hypertension were enrolled in the study. During total cardiopulmonary bypass, 8 patients underwent continuous perfusion of the pulmonary arteries (perfusion group), and the remaining 6 patients did not (control group). Plasma levels of circulating intercellular adhesion molecule 1, soluble granule membrane protein 140, and sialyl Lewis(x) and PaO (2)/fraction of inspired oxygen ratios were measured before commencement and serially for 24 hours after termination of bypass. RESULTS: Plasma levels of circulating intercellular adhesion molecule 1 decreased significantly at the termination of bypass in both groups but returned to prebypass levels immediately in the control group, whereas in the perfusion group the values remained significantly less than those before bypass. Plasma levels of soluble granule membrane protein 140 in the control group were significantly higher at 6 and 12 hours after bypass than levels before bypass, whereas in the perfusion group the values remained at the prebypass level throughout the postbypass period. Trends of plasma levels of sialyl Lewis(x) were alike in both groups. PaO (2)/fraction of inspired oxygen ratios in the control group decreased significantly from 6 hours after bypass, whereas values in the perfusion group remained at the prebypass value throughout the postbypass period. CONCLUSIONS: This study suggests that in infants having congenital heart disease and pulmonary hypertension, continuous pulmonary perfusion during total cardiopulmonary bypass minimizes ischemic insult and neutrophil-endothelial interaction mediated by adhesion molecules in the pulmonary microvessels. SN - 0022-5223 UR - https://www.unboundmedicine.com/medline/citation/11479496/Continuous_perfusion_of_pulmonary_arteries_during_total_cardiopulmonary_bypass_favorably_affects_levels_of_circulating_adhesion_molecules_and_lung_function_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(01)78954-4 DB - PRIME DP - Unbound Medicine ER -