Acute pulmonary hypertension after cardiopulmonary bypass in pig:: the role of endogenous endothelin
Acute pulmonary hypertension after cardiopulmonary bypass in pig:: the role of endogenous endothelin
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DOI：
10.1016/s1010-7940(99)00017-2
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发表时间：
1999-03-01
影响因子：
3.4
通讯作者：
Villemot, JP
中科院分区：
文献类型：
--
作者：
Carteaux, JP;Roux, S;Villemot, JP
背景：体外循环术后发生的急性肺动脉高压是导致术后并发症和死亡率的原因之一。本研究旨在探讨非肽类混合内皮素拮抗剂波生坦对实验性体外循环所致肺动脉高压的影响。方法：麻醉猪，测量血流动力学参数。猪随机分为3 mg/kg团注+7 mg/kg/h波生坦(n=8)或生理盐水(n=7)。所有的猪都接受了90分钟的体外循环，并进一步观察了120分钟。结果：在对照组，体外循环可引起明显的肺动脉高压(+78+/-13%，P<；0.005)，并伴有肺血管阻力增加(+228+/-50%，P<；0.005)；而在治疗组，博生坦仅适度降低体循环阻力(-19+/-14.68，P<；0.05)。结论：目前的研究结果是否属实？内源性内皮素是体外循环术后急性肺动脉高压的介质的假说。波生坦是一种混合内皮素拮抗剂，可完全预防体外循环后的肺动脉高压，因此在心脏手术后的管理中可能有治疗应用。(C)1999 Elsevier Science B.V.保留所有权利。
Background: Acute pulmonary hypertension occurring after cardiopulmonary bypass can be a cause of post-operative morbidity and mortality. The purpose of this study was to investigate whether bosentan, a non-peptidic mixed endothelin antagonist affected the pulmonary hypertension induced by experimental cardiopulmonary bypass. Methods: Pigs were anesthetized and instrumented to determine hemodynamic measurements. Pigs were randomized to receive either 3 mg/kg bolus + 7 mg/kg per h bosentan (n = 8) or saline (n = 7). All pigs underwent 90 min of cardiopulmonary bypass and were further observed for a 120-min period. Results: In the control group, cardiopulmonary bypass induced a dramatic pulmonary hypertension (+78 +/- 13%, P < 0.005) and accompanied an increase of pulmonary vascular resistance (+228 +/- 50%, P < 0.005), whereas, in the treated group, bosentan completely prevented these deleterious effects of cardiopulmonary bypass with only a moderate decrease of systemic vascular resistance (-19 +/- 14.68, P < 0.05). Conclusions: The present findings supper? the hypothesis that endogenous endothelin is a mediator of acute pulmonary hypertension occurring after cardiopulmonary bypass. Bosentan, a mixed endothelin antagonist completely prevented pulmonary hypertension after cardiopulmonary bypass and may, therefore, have therapeutic applications in the management of patients following cardiac surgery. (C) 1999 Elsevier Science B.V. All rights reserved.