May pentoxifylline improve lung function after one-lung flooding?
One-lung flooding makes the intraoperative sonography of round pulmonary lesions possible. During the flooded phase, the flooded lung suffers a significant reduction in perfusion. After ischemia and reperfusion, neutrophil granulocytes lead to further tissue injuries. A study was made on four animals to determine whether administration of pentoxifylline--a potent inhibitor of granulocyte adhesion to the endothelium--improves lung function after one-lung flooding. Two animals were subjected to thoracotomy with extended hemodynamic monitoring. Thoracoscopy was performed on two other animals, which were extubated after the flooding liquid was drained and survived for 24 degrees h. A bolus of 1 mg/kg of pentoxifylline was administered at the time of thoracotomy/thoracoscopy. followed by continuous infusion of pentoxifylline at a rate of 1.5 mg/kg per hour until 30 degrees min after reventilation (thoracotomy), or until extubation, respectively. The control group consisted of animals employed in previous experiments. Except for pentoxifylline administration, they were subjected to identical experimental conditions. The control group for the thoracotomy experiment comprised 14 animals, that for the thoracoscopy experiment three animals. The experiments proved that 30 degrees min after the draining of the flooding liquid and reventilation, all four pentoxifylline-treated animals had a higher partial arterial oxygen pressure and a lower pulmonary shunt volume compared with the control animals. In the two animals that survived, a positive effect on lung function was no longer detectable 24 degrees h after extubation. The administration did not lead to a drop in the pulmonary arterial pressure and did not cause any hemodynamic changes other than a moderate tachycardia.
Klinik für Anästhesiologie und Intensivtherapie, Friedrich-Schiller-Universität Jena, Germany. stefan.klinzing@med.uni-jena.de
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Klinzing
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Lesser
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Schubert
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Bartel
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Klein
D000818:Animals; D002465:Cell Movement / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D005260:Female; D007431:Intraoperative Complications / Q000188:drug therapy; D008168:Lung / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D009504:Neutrophils / Q000187:drug effects / Q000473:pathology; D010431:Pentoxifylline / Q000008:administration & dosage*; D015427:Reperfusion Injury / Q000473:pathology* / Q000503:physiopathology / Q000517:prevention & control*; D013552:Swine; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D010431:Pentoxifylline