Effect of sternotomy and extracorporeal circulation on pulmonary neutrophil kinetics in pigs.
Pulmonary margination of neutrophils may contribute to lung damage after extracorporeal circulation for cardiac surgery. We evaluated single-pass pulmonary neutrophil kinetics using the multiple indicator-dilution technique in control pigs (n = 10), after sternotomy alone (sterno, n = 10) or after 30 min of observation following a period of 90 min extracorporeal circulation (n = 7). Blood neutrophils increased in the control and sterno groups (p < 0.05) but remained unchanged in the extracorporeal circulation group. The transfer coefficient for neutrophil margination from the circulating to the lung-marginated pool (k(c-m)) and pulmonary neutrophil clearance (Cl(c-m)) were similar between the three groups. There was an inverse correlation between k(c-m) and the degree of lung tissue perfusion evaluated from the tracer-accessible extravascular lung water (r = -0.54, p < 0.01). There was no arterio-venous gradient of neutrophils in any of the groups, suggesting a dynamic equilibrium of the margination/demargination processes. We conclude that extracorporeal circulation does not significantly modify single pass pulmonary neutrophil kinetics 30 min after reperfusion. The rate of neutrophil margination to the tracer-accessible lung tissue suggests that lung tissue de-recruitment is associated with increased neutrophil margination.
Salamand
Agnés
A
Department of Cardiology, CHU of Timone Saint-Pierre St., 13385, Marseille, Cedex, France.
Schwab
Andreas J
AJ
Merhi
Yahye
Y
Perrault
Louis P
LP
Simard
André
A
Dupuis
Jocelyn
J
D000818:Animals; D002448:Cell Adhesion / Q000276:immunology; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D008168:Lung / Q000276:immunology*; D020556:Neutrophil Infiltration / Q000276:immunology; D009504:Neutrophils; D013249:Sternum / Q000601:surgery*; D013552:Swine