L-arginine administration during reperfusion improves pulmonary function.
BACKGROUND
Nitric oxide is crucial to the maintenance of vascular homeostasis. Because nitric oxide levels decline upon lung reperfusion, infusion of L-arginine, a nitric oxide precursor, during reperfusion might prove effective at ameliorating reperfusion injury.


METHODS
Neonatal piglet heart-lung blocks were preserved with Euro-Collins solution for 12 hours, rewarmed at room temperature for 1 hour, and reperfused for 10 minutes with either whole blood (n = 5), whole blood containing L-arginine (10 mmol/L; n = 6), or leukocyte-depleted blood (n = 6) on an isolated, blood-perfused, working heart-lung circuit. After the initial 10 minutes, all blocks received whole blood for 4 hours. Control blocks were continuously perfused on the circuit without intervening ischemia (n = 6).


RESULTS
The partial pressure of oxygen in the whole blood group (113.8 +/- 33.1 mm Hg) was significantly less than in controls (417.3 +/- 6.2 mm Hg; p < 0.01). Lung compliance was significantly less in the whole blood group (0.8 +/- 0.2 mL/cm H2O) than in controls (2.9 +/- 0.4 mL/cm H2O; p < 0.01). The L-arginine and leukocyte-depleted blood groups showed no significant difference from controls.


CONCLUSIONS
L-Arginine infusion during reperfusion improves pulmonary function, making it a simple alternative to leukocyte depletion.
Shiraishi
Y
Y
Division of Cardiothoracic Surgery, University of California, Los Angeles, Medical Center 90095, USA.
Lee
J R
JR
Laks
H
H
Waters
P F
PF
Meneshian
A
A
Blitz
A
A
Johnson
K
K
Lam
L
L
Chang
P A
PA
D000818:Animals; D000831:Animals, Newborn; D001120:Arginine / Q000494:pharmacology*; D006321:Heart / Q000503:physiopathology; D066298:In Vitro Techniques; D008168:Lung / Q000098:blood supply* / Q000503:physiopathology; D008170:Lung Compliance; D009569:Nitric Oxide / Q000378:metabolism; D009926:Organ Preservation; D010100:Oxygen / Q000097:blood; D015427:Reperfusion Injury / Q000517:prevention & control*; D013318:Stroke Volume; D013552:Swine; D014655:Vascular Resistance
D009569:Nitric Oxide; D001120:Arginine; D010100:Oxygen