title: Tissue hypoxaemia causes oedema, inflammation and fibrosis in porcine bronchial transsection.
abstract: OBJECTIVE
  Bronchial artery revascularization in lung transplantation is disputed. This study examined the physiological consequences of porcine bronchial transsection and reanastomosis with and without bronchial artery blood supply with relation to lung transplantation.
  
  
  METHODS
  Translational, controlled animal study. Twelve pigs were operated through a left lateral thoracotomy. The left bronchus was transsected and reanastomosed. In the control group (n = 6), the bronchial arteries were preserved and in the study group (n = 6) they were severed. Bronchial mucosa blood flow (BMBF) was measured with laser-Doppler velocimetry and bronchial mucosa haemoglobin saturation and concentration with diffuse reflectance spectrophotometry. Measurements were made preoperatively, postoperatively and after 1 week.
  
  
  RESULTS
  In the study group, left postoperative BMBF was significantly lower than preoperatively (115 vs. 210 PU/s, p = 0.0001) and lower than in the control group (115 vs. 205 PU/s, p = 0.002). Repeated measurement ANOVA showed a significant treatment effect depending on time (p = 0.0034). The left mucosal haemoglobin saturation in the study group was significantly reduced postoperatively, 92% versus 61%, with a treatment effect depending on time (p = 0.0080). The reduction in left/right ratio of the mucosal haemoglobin concentration 1 week postoperatively in the study group was insignificant.
  
  
  CONCLUSIONS
  Bronchial transsection and reanastomosis without bronchial artery blood supply was followed by significant decrease in mucosal blood flow and saturation postoperatively, and also in tissue haemoglobin concentration at section, and provides a physiologic explanation of histological changes.
authors.affiliation: Department of Cardiothoracic Surgery RT, Rigshospitalet, Copenhagen University Hospital, Denmark. gade.john@gmail.com
authors.forename: John
authors.initials: J
authors.lastname: Gade
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.forename: Inge Kristine
authors.initials: IK
authors.lastname: Larsen
authors.forename: Bo Martin
authors.initials: BM
authors.lastname: Bibby
authors.forename: Peter Skov
authors.initials: PS
authors.lastname: Olsen
mesh_terms: D000792:Angiography; D000818:Animals; D001980:Bronchi / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D001981:Bronchial Arteries / Q000601:surgery*; D001991:Bronchitis / Q000209:etiology; D004487:Edema / Q000209:etiology; D005260:Female; D005355:Fibrosis; D006454:Hemoglobins / Q000378:metabolism; D000860:Hypoxia / Q000150:complications*; D017078:Laser-Doppler Flowmetry; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods*; D020545:Respiratory Mucosa / Q000098:blood supply* / Q000378:metabolism; D013053:Spectrophotometry; D013552:Swine
chemical_list: D006454:Hemoglobins