Total liquid ventilation reduces lung injury in piglets after cardiopulmonary bypass
Total liquid ventilation reduces lung injury in piglets after cardiopulmonary bypass
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DOI：
10.1016/j.athoracsur.2006.02.018
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发表时间：
2006-07-01
影响因子：
4.6
通讯作者：
Wu, Song
中科院分区：
文献类型：
--
作者：
Jiang, Lijun;Wang, Qiang;Wu, Song
背景。体外循环可能导致传统治疗无效的肺损伤。全液体通气已成为严重肺损伤的一种替代通气策略。本研究旨在探讨全液体通气对仔猪体外循环术后肺损伤的影响。在心脏骤停和体外循环60分钟后，12头仔猪（4.2 +/- 0.3 kg）随机接受常规气体通气（对照组）或全液体通气（研究组）240分钟。在体外循环术前和术后每隔30分钟采集血样进行血气分析。通过组织学检查量化肺损伤程度。分析支气管肺泡灌洗液中炎性细胞及白细胞介素-6、白细胞介素-8、髓过氧化物酶水平。研究组支气管肺泡灌洗液中性粒细胞和巨噬细胞计数显著降低(52.4 +/- 6.82 vs 0.46 +/- 0.11 10(4)/mL；58.33 +/- 0.88 vs 4.37 +/- 0.90 105/ mL；P < 0.001)。研究组的炎症评分和总肺损伤评分也降低（4.39 +/- 1.14 vs 2.61 +/- 1.09; 11.06 +/- 1.66 vs 6.94 +/- 1.43, p < 0.05）。研究组支气管肺泡灌洗液中白细胞介素-6和髓过氧化物酶浓度显著降低（81.32 +/- 15.23 vs 53.55 +/- 15.48 pg/mL, 75.00 +/- 9.19 vs 50.00 +/- 7.37 u/mL, p < 0.05），而白细胞介素-8水平在两组间相似（551.63 +/- 119.34 vs 563.68 +/- 137.14 pg/mL, p < 0.05）。全液体通气FC-77 （3M, St. Paul， MN）可减少体外循环后仔猪的生化和组织学肺损伤。
Background. Cardiopulmonary bypass may cause lung injury that does not respond to traditional therapies. Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury. The aim of this study is to investigate the effect of total liquid ventilation on lung injury in piglets after cardiopulmonary bypass.Methods. After exposure to 60 minutes of cardiac arrest and weaning from cardiopulmonary bypass, 12 piglets (4.2 +/- 0.3 kg) were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes. Samples for blood gas analysis were collected before, and at 30-minute intervals after, cardiopulmonary bypass. The degree of lung injury was quantified by histologic examination. The inflammatory cells and the levels of interleukin-6, interleukin-8, and myeloperoxidase in bronchoalveolar lavage were analyzed.Results. Neutrophil and macrophage count in bronchoalveolar lavage were significantly decreased in the study group (52.4 +/- 6.82 vs 0.46 +/- 0.11 10(4)/mL; 58.33 +/- 0.88 vs 4.37 +/- 0.90 105/ mL; p < 0.001, respectively). The inflammation score and the total lung injury score were also reduced in the study group (4.39 +/- 1.14 vs 2.61 +/- 1.09; 11.06 +/- 1.66 vs 6.94 +/- 1.43; p < 0.05, respectively). The concentrations of interleukin-6 and myeloperoxidase in bronchoalveolar lavage were significantly reduced in the study group (81.32 +/- 15.23 vs 53.55 +/- 15.48 pg/mL, 75.00 +/- 9.19 vs 50.00 +/- 7.37 u/mL; p < 0.05, respectively), whereas the interleukin-8 levels were similar between both groups (551.63 +/- 119.34 vs 563.68 +/- 137.14 pg/mL, p > 0.05).Conclusions. Total liquid ventilation with FC-77 (3M, St. Paul, MN) reduces biochemical and histologic lung injury in piglets after cardiopulmonary bypass.