title: Na /H+ exchange inhibitor cariporide: effects on respiratory dysfunction after cardiopulmonary bypass.
abstract: The purpose of the present study was to evaluate the potential of the Na+/H+ exchange inhibitor cariporide to protect the lung from injury after cardiopulmonary bypass (CPB). In a randomized placebo-controlled study, 16 pigs were subjected to CPB for 75 min. Administration of vehicle or cariporide (bolus 180 mg, 40 mg/hour) began 30 min pre-CPB and was continued throughout the protocol. The alveolo-arterial O2-gradient (AaDO2), the pulmonary shunt (Qs/Qt), the compliance (Cpl), haemodynamic variables and glycerol and water content in lung tissue were measured 10 min before and up to 180 min post-CPB. All animals in the control versus 75% in the cariporide group survived the experiment. At 5 and 60 min post-CPB, the mean AaDO2 and at 5, 60 and 180 min post-CPB, the mean pulmonary vascular resistance index were higher in the cariporide group (p < 0.05), respectively. More lung water accumulation was found in the cariporide group (p < 0.05). Mean Cpl decreased; the Qs/ Qt and glycerol in lung tissue increased without significant intergroup difference. In this model, the inhibitor of the Na+/H+ antiporter showed no protective effect on lung injury after CPB and might even have harmful effects on pulmonary vascular tone and function.
authors.affiliation: Department of Anaesthesiology, University of Luebeck, Germany. eichler@medinf.mu-luebeck.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eichler
authors.forename: Matthias J F
authors.initials: MJ
authors.lastname: Bechtel
authors.forename: Stephan
authors.initials: S
authors.lastname: Klaus
authors.forename: Matthias
authors.initials: M
authors.lastname: Heringlake
authors.forename: Mario
authors.initials: M
authors.lastname: Hernandez
authors.forename: Kai
authors.initials: K
authors.lastname: Toerber
authors.forename: Karl-Friedrich
authors.initials: KF
authors.lastname: Klotz
authors.forename: Claus
authors.initials: C
authors.lastname: Bartels
mesh_terms: D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D015633:Extravascular Lung Water / Q000187:drug effects / Q000378:metabolism; D006146:Guanidines / Q000097:blood / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D017551:Microdialysis; D011652:Pulmonary Circulation / Q000187:drug effects; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D011897:Random Allocation; D012120:Respiration Disorders / Q000209:etiology* / Q000503:physiopathology*; D017923:Sodium-Hydrogen Exchangers / Q000037:antagonists & inhibitors*; D013450:Sulfones / Q000097:blood / Q000494:pharmacology*; D013552:Swine
chemical_list: D006146:Guanidines; D017923:Sodium-Hydrogen Exchangers; D013450:Sulfones; C093373:cariporide