The effect of pulsatile cardiopulmonary bypass on lung function in elderly patients
The effect of pulsatile cardiopulmonary bypass on lung function in elderly patients
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DOI：
10.5301/ijao.5000352
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发表时间：
2014-09-01
影响因子：
1.7
通讯作者：
Faggian, Giuseppe
中科院分区：
文献类型：
--
作者：
Engels, Gerwin E.;Dodonov, Mikhail;Faggian, Giuseppe
目的：体外循环仍是心脏手术后肺损伤和延迟肺功能恢复的主要原因。尽管已经表明，由主动脉内球囊泵送诱导的脉动流有利于保护肺功能，但尚不清楚在体外回路中产生的脉动流是否可以实现相同的有益效果。因此，我们研究了脉动流的效果，产生的离心泵，对肺功能的老年patients.Methods：肺生物标志物克拉拉细胞16 kD蛋白，表面活性蛋白D，和弹性蛋白酶的系列测量进行血液样本从37例老年患者（>= 75岁）进行了选择性主动脉瓣置换术与CPB，无论是与脉动灌注或连续灌注。结果：两组患者术后通气时间、动脉血氧分压（PaO 2/FiO 2）、肺泡-动脉氧分压差（Aa-O-2）、肺血管阻力（PVRi）无显著性差异。然而，在注入鱼精蛋白后15分钟，脉动灌注组的PVRi显著降低（p
Purpose: Cardiopulmonary bypass is still a major cause of lung injury and delay in pulmonary recovery after cardiac surgery. Although it has been shown that pulsatile flow induced by intra-aortic balloon pumping is beneficial for preserving lung function, it is not clear if the same beneficial effect can be accomplished with pulsatile flow generated in the extracorporeal circuit. Therefore, we investigated the effect of pulsatile flow, produced by a centrifugal pump, on lung function in elderly patients.Methods: Serial measurements of lung biomarkers Clara cell 16 kD protein, surfactant protein D, and elastase were performed on blood samples from 37 elderly patients (>= 75 years) who underwent elective aortic valve replacement surgery with CPB, either with pulsatile perfusion or continuous perfusion. Pulmonary function was assessed by postoperative ventilation time, the arterial blood oxygenation (PaO2/FiO(2)), the alveolar-arterial oxygen gradient (Aa-O-2 gradient) and the pulmonary vascular resistance indexed by body surface area (PVRi).Results: There was no difference in lung function between both groups, as assessed by the postoperative ventilation time, the PaO2/FiO(2) ratio, and the Aa-O-2 gradient. The PVRi, however, was significantly lower in the pulsatile perfusion group 15 mins after the administration of protamine (p