[Influence and significance of intermittent ventilation on lung cytokines during cardiopulmonary bypass].
OBJECTIVE
To determine the influence and significance of intermittent ventilation on lung cytokines during cardiopulmonary bypass (CPB).


METHODS
Thirty-six patients with rheumatic heart disease (RHD) were divided into 2 groups randomly: Treatment group (n = 18, given intermittent ventilation once every 5 minutes during CPB; control group ( n = 18), no ventilation during CPB. A brochioalveolar lavage was performed at 2 hours after the CPB. The numbers of granulocytes and the contents of IL-1, IL-6, TNF-alpha, and LDH in the brochioalveolar lavage fluids were measured, and lung PaO2/FiO2 were measured preoperatively and at 1 hour, 4 hours, and 8 hours after the CPB termination.


RESULTS
The numbers of granulocytes and the contents of IL-1, IL-6, TNF-alpha, and LDH of the treatment group in the brochioalveolar lavage fluids were significantly lower than those of the control group (P < 0.05), and the lung PaO2/FiO2 of the treatment group at 1 hour, 4 hours, and 8 hours after the CPB termination significantly increased than those of the control group (P < 0.05). A significant decrease of lung PaO2/FiO2 occurred in both groups at 1 hour, 4 hours, and 8 hours after the CPB compared with the same group at the baseline before the CPB (P < 0.01).


CONCLUSIONS
Intermittent ventilation has protective effects on the lung injury during CPB by decreasing granulocyte adhesion and the level of lung cytokines, alleviating the lung inflammatory reaction and endothelial cell injury.
Wang
Dian-jun
DJ
Department of Cardiothoracic Surgery, Third Xiangya Hospital, Central South University, Changsha, China. wangdianjun5128@yahoo.com.cn
Yin
Bang-liang
BL
Liu
Jian-xi
JX
Zhang
Qing-chun
QC
Hong
Chao
C
Jin
Long-yu
LY
D000328:Adult; D002315:Cardiopulmonary Bypass; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007384:Intermittent Positive-Pressure Breathing; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000503:physiopathology / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha