| ObjectThe injury to the lung function of congenital heart disease with pulmonary hypertension is serious during cardiopulmonary bypass (CPB). The aim of this study was to determine the effect of pulmonary perfusion with HTK solution on lung function during cardiopulmonary bypass.MethodsBetween Aug.2008 and Sep.2009,40 congenital heart disease patients with pulmonary hypertension were randomly divided into two groups. Male:23 cases, Female:17 cases. Age:3～18 months, average (8±4.5)months. Weight:4.2～11.5 kg, average (6.8±3.4) kg. All patients were diagnosised acrossed of electrocardiography,echocardiography,chest radiography,and blood gases. There were VSD 12 cases,VSD+PDA 8 cases,VSD+ASD 10 cases,TAPVC 6 cases,AVSD 4 case. Each group have 20 cases.The anesthesia method of inhalation combined with vein injection were used There was no difference. Once the pericardium was entered, the pulmonary pressure were meassured. After cardiopulmonary bypass was established, the aortic cross-clamp was applied, and all the patients hearts were arrested with 4℃HTK solution. Perfusion flow was 40ml/kg, and the perfusion time was 7 mins. Before operation, There was no different treatments among the two groups. During CPB, the study group were perfused with 4℃HTK solution to pulmonary artery, 25ml/kg, the pressure was controled between 30～40cm H20. The control group were not. All patients pulmonary pressure were meassured after CPB. IL-6,MDA,RI and 01 were measured before bypass,at the end of bypass,6h after bypass,12h after bypass,24h after bypass.Statistic analysis was used with SPSS 13.0 statistic software to analyze all the patients'data.ResultsAfter operation, The pulmonary pressure of all the patients were lower than before operation (P<0.05). But there was no significant diffference among the two groups (P>0.05). The plasma levels of IL-6 and MDA in study group was lower than that in control group and the difference was significant (P<0.05). At each measuring point OI of the study group was significantly higher than that of the control group (P< 0.05). The RI of study group were significantly lower than that of control group (P< 0.05) after CPB.ConclusionsPulmonary artery perfusion with HTK solution was able to reduce the plasma levels of IL-6 and MDA. The patients lung function recovered more quickly. This study demonstrated that pulmonary artery perfusion with HTK solution can obviously reduce lung injury after cardiopulmonary bypass. |
