Autologous lung used as a substitute of oxygenator in cardiopulmonary bypass can preserve postoperative respiratory function.
We substituted autologous lung for the artificial oxygenator to assess reduction of lung injury after conventional cardiopulmonary bypass (CPB). Twelve piglets were randomly divided into two groups. Experimental animals (n = 6) underwent bilateral CPB with autologous lungs perfusion, whereas control animals (n = 6) underwent conventional CPB with artificial oxygenator. Bypass and aortic cross clamping time were 135 and 60 minutes, respectively, for each animal. Lung static compliance (Cstat), alveolus-artery oxygen difference (PA-aO2), tumor necrosis factor (TNF)-alpha, interleukin-6, and wet to dry lung weight ratio (W/D) were measured. A single senior pathologist evaluated the lung specimens after experiments. Cstat of experimental group and control group decreased from 14.31 +/- 1.58 to 12.88 +/- 1.92 ml/cmH2O and from 14.80 +/- 2.32 to 10.48 +/- 1.66 ml/cmH2O, respectively; PA-aO2 increased from 15.71 +/- 1.35 to 62.30 +/- 24.29 mm Hg and from 15.23 +/- 2.87 to 77.85 +/- 11.45 mm Hg, respectively; serum concentration of TNF-alpha increased from 0.40 +/- 0.07 ng/ml to 0.56 +/- 0.15 and from 0.41 +/- 0.06 to 0.75 +/- 0.14 ng/ml, respectively; and the w/d were 6.18 +/- 0.55 vs 6.84 +/- 0.30. Pathological examination also confirmed that structural changes of lung specimens were less in experimental group than in control group. Autologous lung may tolerate nonpulsatile perfusion and be used clinically as a substitute for the artificial oxygenator to reduce lung injury after CPB.
Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Xinhua Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
Huimin
H
Huang
Xiang
X
Kong
Demin
D
Zhu
Wei
W
Wang
Haibo
H
Zhang
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005260:Female; D015850:Interleukin-6 / Q000097:blood; D008168:Lung / Q000473:pathology / Q000503:physiopathology*; D008170:Lung Compliance; D008171:Lung Diseases / Q000517:prevention & control; D008854:Microscopy, Electron; D009929:Organ Size; D010100:Oxygen / Q000097:blood; D010106:Oxygenators; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D011650:Pulmonary Alveoli; D011651:Pulmonary Artery; D012119:Respiration; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D010100:Oxygen