title: Reduction of neutrophil margination by L-arginine during hypothermic cardiopulmonary bypass in a pig model.
abstract: 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.
authors.affiliation: Department of Radiology, University of Miami, School of Medicine, Florida, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Dewanjee
authors.forename: S M
authors.initials: SM
authors.lastname: Wu
authors.forename: D
authors.initials: D
authors.lastname: De
authors.forename: R
authors.initials: R
authors.lastname: Nadkarni
authors.forename: L
authors.initials: L
authors.lastname: Gonzalez
authors.forename: S
authors.initials: S
authors.lastname: Dewanjee
authors.forename: S
authors.initials: S
authors.lastname: Novak
authors.forename: R A
authors.initials: RA
authors.lastname: Perryman
authors.forename: A N
authors.initials: AN
authors.lastname: Serafini
authors.forename: G N
authors.initials: GN
authors.lastname: Sfakianakis
authors.forename: R C
authors.initials: RC
authors.lastname: Duncan
authors.forename: W D
authors.initials: WD
authors.lastname: Dietrich
authors.forename: W I
authors.initials: WI
authors.lastname: Ganz
authors.forename: L C
authors.initials: LC
authors.lastname: Hsu
mesh_terms: D000818:Animals; D001120:Arginine / Q000008:administration & dosage / Q000494:pharmacology*; D001921:Brain / Q000166:cytology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D002448:Cell Adhesion; D002465:Cell Movement / Q000187:drug effects; D007036:Hypothermia, Induced; D007205:Indium Radioisotopes; D009503:Neutropenia / Q000209:etiology / Q000517:prevention & control; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D009569:Nitric Oxide / Q000097:blood; D013552:Swine
chemical_list: D007205:Indium Radioisotopes; D009569:Nitric Oxide; D001120:Arginine