Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass

Asimakopoulos, George; Smith, Peter; Ratnatunga, Chandana; Taylor, Kenneth M.

doi:10.1016/s0003-4975(99)00781-x

Cited by 369 publications

(291 citation statements)

References 78 publications

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“…It is well known that PMNs play a key role in the development of post-CPB lung injury 1-5,22. Previous studies showed that volatile anaesthetics reduced PMN adhesion in the reperfused coronary system 33,34.…”

Section: Discussionmentioning

confidence: 99%

“…During CPB, blood contact with the artificial surface of the bypass circuit, coupled with IR injury contribute to the initiation of SIRS which is partially attributed to activation of PMNs with up-regulation of adhesion molecules. This process may ultimately result in adhesion of PMNs to the endothelium of the lung vessels, and endothelial damage due to protease release 1. Researchers in multi-disciplinary fields have been attempting to find better lung protective and therapeutic strategies against CPB-associated lung injury.…”

Section: Discussionmentioning

confidence: 99%

“…The lungs are one of the most susceptible organs to ischaemia/reperfusion (IR) injury and systemic inflammatory response syndrome (SIRS) initiated during cardiopulmonary bypass (CPB) 1. Laboratory and clinical investigations have demonstrated that accumulation of polymorphonuclear leukocytes (PMNs) in the lungs plays a key role in the pathogenesis of CPB-related lung injury, which leads to impairment of gas exchange, increase in pulmonary vascular resistance (PVR) and decrease in pulmonary compliance 1-5…”

Section: Introductionmentioning

confidence: 99%

“…Laboratory and clinical investigations have demonstrated that accumulation of polymorphonuclear leukocytes (PMNs) in the lungs plays a key role in the pathogenesis of CPB-related lung injury, which leads to impairment of gas exchange, increase in pulmonary vascular resistance (PVR) and decrease in pulmonary compliance 1-5…”

Section: Introductionmentioning

confidence: 99%

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Isoflurane pre-treatment before cardiopulmonary bypass alleviates neutrophil accumulation in dog lungs

Gao²,

Liu³

et al. 2011

CardioVascular Journal of Africa

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ObjectiveThis study investigated the effect of isoflurane pre-treatment on cardiopulmonary bypass (CPB)-related lung injury.MethodsTwelve dogs were randomly divided into two groups of six each. In one group, 1.0 minimum alveolar concentration (MAC) of isoflurane was administered for 30 min before CPB, while the control group received no anaesthetic. Both groups then underwent 100 min of mild hypothermic CPB with 60-min aortic cross clamping. Haemodynamic parameters, respiratory mechanics and alveolar arterial oxygen difference (AaDO2) were measured during the experiment. One hundred and fifty minutes after CPB, lung tissue samples from the non-dependent and dependent portions of the left and right lungs were harvested for polymorphonulear leukocyte (PMNs) counts.ResultsFollowing CPB, within the control group, pulmonary vascular resistance (PVR) was significantly increased at 60, 120 and 180 min after declamping, AaDO2 deteriorated at 180 min post-declamping, and dynamic lung compliance (DLC) was reduced dramatically after declamping. Isoflurane pre-treatment before CPB significantly reduced PVR compared to the controls. AaDO2 was impaired at 180 min after declamping and DLC was decreased after declamping within the isoflurane group. No differences in AaDO2 and DLC were found between the isoflurane and control groups. At 180 min after declamping, the PMN count in both the non-dependent and dependent regions of the isoflurane pre-treated lungs was significantly lower than that of the controls.ConclusionsOur results suggest that 30-min pre-treatment with 1.0 MAC isoflurane before CPB caused a reduction in PMN accumulation in the dog lungs, inhibition of increases in PVR, and it did not affect AaDO2 in the early post-CPB stage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Isoflurane pre-treatment before cardiopulmonary bypass alleviates neutrophil accumulation in dog lungs

Gao²,

Liu³

et al. 2011

CardioVascular Journal of Africa

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show abstract

“…9 Cardiopulmonary bypass, which takes over the function of the heart and lungs during surgery, involves risks from factors including blood contact with artificial material, administration of heparin-protamine, hypothermia, and lung ventilatory arrest, leading to the activation of pathways of systemic inflammatory response. 10 Lung injury after cardiopulmonary bypass, also known as "post-bypass lung," 11 is associated with functional, physiologic, biochemical, and histological changes.…”

Section: See the Original Study On Page 186mentioning

confidence: 99%

Tailoring Noninvasive Ventilation Management in Non-ICU Settings and the Cardiac Surgery Context

Koutsogiannidis

Ananiadou

2014

Respir Care

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Prophylactic corticosteroids for cardiopulmonary bypass in adults

Dieleman¹,

Klarenbosch²

2006

Cochrane Database of Systematic Reviews

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Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass

Cited by 369 publications

References 78 publications

Isoflurane pre-treatment before cardiopulmonary bypass alleviates neutrophil accumulation in dog lungs

Isoflurane pre-treatment before cardiopulmonary bypass alleviates neutrophil accumulation in dog lungs

Tailoring Noninvasive Ventilation Management in Non-ICU Settings and the Cardiac Surgery Context

Prophylactic corticosteroids for cardiopulmonary bypass in adults

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