The Protective Effect Of Prostaglandin E₁ On Lung During Cardiopulmonary Bypass

Objective: To investigate the protective effect ofprostaglandin E₁ (PGE₁) on lung by regulating inflammatory systemduring cardiopulmonary bypass (CPB). Methods: From March to June in2006, a total of 24 patients with rheumatic valvular disease undergoingcardiac surgery were randomly divided into the control group (n=12) andthe test group (n=12). Each patient in the test group received 15ng.kg^-1.min^-1 of PGE₁ from the induction of anaesthesia to the end ofCPB.PMN and Plt in the blood in left and right atrium were measured at5 min before CPB and 15 min after heart resuscitation. The levels ofsE-selectin, C-reactiveprotein(CRP), interleukin-6(IL-6), interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α) in serum were measured at 5 minbefore CPB, 30 min on CPB, 15 rain after heart resuscitation, 1 h and 6 hafter CPB. Oxygenation index(OI), compliance of lung (CL), peak airwaypressure(P_peak) and plateau airway pressure(P_plat) were also recorded inboth groups. Results:â‘ PMN and Plt count in the blood in left atriumwere significantly lower than those in right atrium in the control group at15 min after heart resuscitation (p＜0.01).â‘¡During and after CPB, the level of sE-selectin increased in both groups, but it was significantlyhigher in the control group than that in the test group (p＜0.01).â‘¢Duringand after CPB, the level of CRP in the test group was significantly lowerthan that in the control group (p＜0.01).â‘£The levels of IL-6, IL-8 andTNF-A in the control group were significantly higher than that in the testgroup(p＜0.01) after CPB.⑤Compared with the control group, OI wassignificantly lower(p＜0.01) and CL was significantly higher in the testgroup(p＜0.01) at the end of CPB.â‘¥P_peak and P_plat in both groupsdecreased after stemotomy and increased at the end of operation. Theywere significantly higher in the control group than those in the testgroup(p＜0.01) Conclusions: 1. The systemic inflammatory responsetriggered by CPB leads to the release of cytokines and the damage ofpulmonary endothelial cells and the function of lungs. 2. PGE₁ caneffectively reduce the sequestration of neutrophil and platelet in the lung,decrease the levels of Il-6, IL-8 and TNF-αin serum, inhibit theactivation of vascular endothelial cells and protect lungs during CPB.