Dexamethasone and pentastarch produce additive attenuation of ischaemia/reperfusion lung injury.
The choice of an intravenous solution for the attenuation of ischaemia/reperfusion (I/R) lung injury is still a difficult one. Although 10% (w/v) pentastarch has been used in ICU settings, its use in I/R lung injury has not been well explored. We hypothesized that this synthetic colloid substance, which maintains colloid osmotic pressure and potentially 'seals' capillary leaks, in combination with an anti-inflammatory agent (i.e. dexamethasone), would ameliorate I/R lung injury. After 60 min of lung ischaemia in an isolated rat lung model, lungs were reperfused for 60 min in a closed circulating system with one of the following solutions: (1) NS (0.9% normal saline), (2) NS+Dex (dexamethasone), (3) NS+Penta (pentastarch), or (4) NS+Penta+Dex. Haemodynamic changes, lung weight gain (LWG), capillary filtration coefficient (K(fc)) and lung pathology were analysed. Results showed significantly lower values of K(fc) and LWG in pentastarch- or dexamethasone-perfused groups as compared with those in the NS group. Dexamethasone as an additive to NS+Penta further decreased K(fc) and LWG. Histopathological studies showed similar decreases in injury profiles. We conclude that reperfusion with dexamethasone and pentastarch can attenuate I/R lung injury, and that dexamethasone and pentastarch have additive effects. Our data thus suggest that the combination of a colloid substance with 'sealing effects' and an anti-inflammatory agent may provide a better reperfusion solution for patients with I/R lung injury or for lungs stored for transplant.
Chiang
C H
CH
Pulmonary Division, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. chchiang@ndmctsgh.edu.tw
Wu
C P
CP
Perng
W C
WC
Yan
H C
HC
Yu
C P
CP
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002199:Capillary Permeability / Q000187:drug effects; D003907:Dexamethasone / Q000494:pharmacology / Q000627:therapeutic use*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006439:Hemodynamics; D006895:Hydroxyethyl Starch Derivatives / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008171:Lung Diseases / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000503:physiopathology; D015430:Weight Gain / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D003907:Dexamethasone