Pulmonary Injury After Cardiopulmonary Bypass And Its Prevention And Control Research Progress

【Objective】Cardiopulmonary bypass (CPB) induces systemic inflammatory response with neutrophil activation and subsequent lung dysfunction. Here, we tested the protective effect of SF on CPB-induced lung IRI and discuss the possible mechanism of it. 【Methods】 Within fifty patients, 10 patients undergone open-chest surgery with heart-beating(NCG), the other 40 patients who were undergoing CPB were randomly divided into contrasted group(CCG) and SF group(SFG),20 in each group. In SF group, SF was injected(0.2g in NS 250ml) via vein Bid for one week preoperatively. In the two contrasted groups, SF was replaced by same volume of NS. The changes of TNF-α,IL-6,IL-8,SOD level in the NCG and CCG were observed from the blood samples of radius artery before operation, 1 hour after open chest and 1 hour after operation.Same data in the CCG and SFG would be examined before operation, at 15min,30min after aortic cross clamp and 1 hour after operation. By the time of 15min and 30min after ACC was opened, blood samples were taken from the right and left atrium to examine the amount of neutrophils. Lung tissues were cut to do pathological studys in some patients.【Result】 The TNF-α,IL-6,IL-8,SOD concentration were not significantly different before the operation between these 3 groups. At 1h during and after the operation, TNF-α,IL-6,IL-8,SOD levels were significantly higher in CCG than NCG(P<0.05). So has the same result in CCG than SFG of TNF-α,SOD at 15min,30min after ACC and 1h after operation(P<0.05). At 15min,30min after ACC, IL-6,IL-8 level was higher in CCG than SFG(P<0.05),while there was no difference at 1h after operation between them. The neutrophils number of right atrium in CCG was much higher than that of left atrium at 30min after ACC was opened(P<0.05).Pathological study of lungs revealed that more alveolar hemorrhage and neutrophil accumulation were observed in the CCG compared to the NCG and SFG. 【Conclusion】 1.CPB heart surgery can acturally cause the systemic inflammatory response syndrome. 2.SF could obviously reduce the activation of systemic inflammatory reaction, prevent lung IRI and has some good protective effects on the pulmonary function during and after CPB.