Pulmonary artery perfusion with protective solution reduces lung injury after cardiopulmonary bypass.

Abstract Background . The inflammatory response and higher temperature of lung tissue during cardiopulmonary bypass can result in lung injury. This study was to evaluate the protective effect of pulmonary perfusion with hypothermic antiinflammatory solution on lung function after cardiopulmonary bypass. Methods . Twelve adult mongrel dogs were randomly divided into two groups. The procedure was carried out through a midline sternotomy, cardiopulmonary bypass was established using cannulas placed in the ascending aorta, superior vena cava, and right atrium near the entrance of the inferior vena cava. After the ascending aorta was clamped and cardioplegic solution infused, the right lung was perfused through a cannula placed in the right pulmonary artery with 4°C lactated Ringer's solution in the control group (n = 6) and with 4°C protective solution in the antiinflammation group (n = 6). Antiinflammatory solution consisted of anisodamine, l-arginine, aprotinin, glucose-insulin-potassium, and phosphate buffer. Plasma malondialdehyde, white blood cell counts, and lung function were measured at different time point before and after cardiopulmonary bypass; lung biopsies were also taken. Results . Peak airway pressure increased dramatically in the control group after cardiopulmonary bypass when compared with the antiinflammation group at four different time points (24 ± 1, 25 ± 2, 26 ± 2, 27 ± 2 cm H 2 O versus 17 ± 2, 18 ± 1, 17 ± 1, 18 ± 1 cm H 2 O; all p −5 versus 845 ± 86 dynes · s · cm −5 and 1,269 ± 124 dynes · s · cm −5 versus 852 ± 149 dynes · s · cm −5 , p 2 ) in the antiinflammation group was higher than in the control group at 60 minutes after cardiopulmonary bypass (628 ± 33.3 mm Hg versus 393 ± 85.9 mm Hg, p p p p Conclusions . Pulmonary artery perfusion using hypothermic protective solution can reduce lung injury after cardiopulmonary bypass.