Air-blood barrier injury during cardiac operations with the use of cardiopulmonary bypass (CPB). An old story? A morphological study.
OBJECTIVE
In spite of the advances in technology and surgical techniques, cardiac surgical operations with the use of cardiopulmonary bypass (CPB) are still associated with pulmonary morbidity and mortality. The purpose of this study is to morphologically analyze the structure of air-blood barriers in patients who underwent coronary artery bypass grafting (CABG) with use of CPB.


METHODS
The investigation involved 50 patients aged 48-75 who underwent CABG with the use of extracorporeal circulation (ECC). Lung tissue specimens, which were taken before and after CPB, were observed with light and electron microscopy.


RESULTS
Both light and electron microscopic observations of pre-pump specimens did not show any pathological changes within the terminal part of the respiratory system. Morphological observations of tissue samples obtained after CPB revealed features of air-blood barrier injury and presence of surfactant within the alveolar capillaries.


CONCLUSIONS
Whatever the mechanism of the aforementioned changes one should be aware that the presented results indicate that air-blood barriers become leaky after CABG is performed with the aid of ECC.
Wasowicz
Marcin
M
John Paul II Hospital, Department of Cardiovascular Surgery, Cracow, Poland. wasowicz_pl@poczta.onet.pl
Sobczyński
Paweł
P
Drwiła
Rafał
R
Marszałek
Andrzej
A
Biczysko
Wiesława
W
Andres
Janusz
J
D000368:Aged; D001706:Biopsy; D015824:Blood-Air Barrier / Q000166:cytology / Q000293:injuries* / Q000473:pathology; D002196:Capillaries / Q000166:cytology / Q000293:injuries / Q000378:metabolism; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000166:cytology / Q000378:metabolism / Q000473:pathology; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008859:Microscopy, Polarization; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology / Q000378:metabolism; D012720:Severity of Illness Index; D013223:Statistics as Topic; D017211:Treatment Failure