The Effects Of Sevoflurane Preconditioning On Cardiopulmonary Bypass Induced Lung Injury In Pediatric Patients

Objective:The purpose of this study was to investigate the protective effects of sevoflurane preconditioning on cardiopulmonary bypass (CPB) induced lung injury in pediatric patients.Method:Forty pediatric patients undergoing open heart repair of ventricular septal defect under CPB, who had no systemic diseases (ASA gradeⅠ-Ⅱ) and weigh 11-20 kg, were randomized grouped into two groups:sevoflurane preconditioning group (S group) and control group (C group), each group has twenty patients. Exclusion criteria were as follows:decompensated cardiac disease (>NYHAⅡ), severe pulmonaryhypertension (MPAP> 45mmHg), respiratory tract or pulmonary disease, pulmonary stenosis and pulmonary valve disease. S group received 2.5Vol%(1MAC) sevoflurane from endotracheal intubation to the beginning of CPB whereas C group was given no inhalation anesthetic. Blood samples were taken from radial artery at the time-points of 5 min after anesthesia(T0), the end of CPB(T1), lh(T2) and 6h(T3) after the end of CPB. Arterial blood gas analysis was given immediately to calculate RI,OI and PaO2/PAO2, and the concentrations of SP-A in blood serum were measured after all samples collected. Statistics treatment:The measurement data was expressed as "x±s", and using repeated measure ANOVA and two-group t-test program of SPSS 13.0 software to analyze it. It has significance when P< 0.05.Results:The sexuality,age,body weight,operation time,CPB time and aortic clamping time had no significant difference between two groups (P>0.05). The lung function markers and the concentrations of blood serum SP-A at T0 had no significant difference between two groups (P>0.05). At T1 and T2,the lung function markers degraded and SP-A concentrations increased significantly compared to baseline (T0) in both groups (P<0.05), and the lung function markers were significantly higher and SP-A concentrations were significantly lower in S group than in C group (P<0.05). At T3, the lung function markers improved and the concentrations of SP-A decreased significantly in both groups, compared with T1 and T2 (P＜0.05). All the targets had no significant difference between T0 and T3 in both groups (P>0.05). And there is no significant difference between two groups at T3.Conclusion:Sevoflurane preconditioning has the protective effect on CPB induced lung injury in pediatric patients.