開心術後肺虚血再濯流障害に対する一酸化窒素(NO)吸入療法の確立

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Method; Fourteen anesthetized mongrel dogs were mechanically ventilated. After 90 min. of the left lung ischemia by the left hilum clamping, the same side lung reperfusion for 150 min. was achieved by declamping of the left hilum and clamping of the opposite side hilum so that all the perfusion and ventilation was supported only by the left lung. Seven dogs inhaled 30ppm NO during reperfusion (Group 1). The other seven dogs were ventilated without NO (Group 2). Hemodynamic parameters, blood gas, superoxide dismutase(SOD)activity and lipid peroxide content in the left atrial blood and the left lung wet/dry ratio at the end of the experiment were analysed.Results; Immediately after reperfusion, systolic pulmonary arterial pressure was significantly lower in Group 1(27.6±4.5mmHg vs 44.3±6.3mmHg,p<0.05).This significant reduction of The pulmonary blood pressure continued throughout reperfusion. Significant improvement was also observed in Group 1 on pulmonary vascular resistance and right ventricular enddiastolic pressure. SOD activity 15 min. after reperfusion in Group 2 droped to 41% of pre-ischemic value. On the other hand, in Group 1, any significant decrease was not observed during reperfusion. Left lung wet / dry ratio was significantly lower in Group 1(4.72±0.36 vs 5.47±0.52,p<0.05).