Cardiovascular effects of induced hypothermia after lung transplantation

Eriksson, Leif; Roscher, Roger; Ingemansson, Richard; Steen, Stig

doi:10.1016/s0003-4975(98)01320-4

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…However, the rise in PVR, which was most prominent in the Constant PPA group, is consistent with previous observations made in various species including rats, pigs, and dogs (8, 17, 21, 30). At variation from isolated lungs that are perfused at constant flow or constant pressure, intact organisms adjust perfusion to the demands of the local tissues in an interaction between peripheral sensors and the central nervous system (31).…”

Section: Discussionsupporting

confidence: 92%

“…Initially, reperfusion takes place against an increased PVR (8, 21, 27). Following cooling of pigs to rectal temperatures of 26–28°C, the investigators observed a drop in cardiac index to approximately one-third of that determined at normal rectal temperature and, simultaneously, a threefold increase in PVR, whereas pulmonary artery pressure remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs

et al. 2016

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BackgroundVictims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow.MethodsIsolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (PLW), which was based on body weight (BW) according to the formula: PLW = 0.0053 BW − 0.48 and presented as KfcPLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p < 0.05 considered as significant.ResultsPerfusate flow remained constant in the Constant flow group, but was more than halved during hypothermia in the Constant PPA group concomitant with a more fold increase in PVR. In the Constant flow group, KfcPLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within the Constant flow group and between the groups at cessation of the experiments.ConclusionIn hypothermic rat lungs perfused at constant flow, fluid filtration coefficient per gram PLW and B/P ratio increased more than 10-fold concerted by increased hemoconcentration, but the changes were less in hypothermic lungs perfused at constant PPA.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs

et al. 2016

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“…In their study, induced hypothermia caused a significant reduction in right ventricular workload, although the pulmonary vascular resistance increased. 89 All published clinical reports in this context are either case reports or case series. As such, their impact on the treatment of PGD is, at the moment, questionable.…”

Section: (C) Other Agents To Prevent or Treat Pgdmentioning

confidence: 99%

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part VI: Treatment

Shargall

Guenther

Ahya

et al. 2005

The Journal of Heart and Lung Transplantation

116

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“…In an intriguing study by Eriksson, and colleagues, induced hypothermia appeared to be beneficial in case studies of PGD patients and was recapitulated in an animal model. (Eriksson and Steen 1998;Eriksson et al 1999) Significant forays into the use of inhaled Nitric Oxide (iNO) as a therapeutic agent have also been made in recent years. There have been discordant results, however as to the efficacy, ranging from no change in outcomes to a decreased incidence of severe PGD and diminished concentrations of IL-6 and IL-8 in plasma compared to controls.…”

Section: Novel/future Therapeutics For Pgdmentioning

confidence: 99%