Effects Of Sevoflurane Administration In Early Stage Of Ischemia And Reperfusion On Serum IL-8,NO And ET-1 In Patients Undergoing Cardiac Valve Replacement Under CPB

Objective:This study aimed to investigate the lung protective effect of 2% sevoflurane in early ischemia and early reperfusion in patients who underwent cardiopulmonary bypass(CPB).The levels of IL-8,NO,endothelin-1 in the serum and the cross-pulmonary mononuclear cell count were observed in patients undergoing cardiopulmonary bypass.Methods:Forty rheumatic heart disease patients scheduled for cardiac valve replacement surgery in cardiopulmonary bypass,were randomly assigned into two groups(n=20 in each group): sevoflurane group and control group.The sevoflurane group(S group)was inhaling 2% sevoflurane 15 min before blocking the ascending aorta,inhaling 15 min after blocking the ascending aorta.Inhaling 2% sevoflurane 15 min before open ascending aorta,inhaling 15 min after open the ascending aorta.The control group(group C)did not inhade sevoflurane,the rest was treated as well as S group.The blood samples were collected to detect the serum levels of NO,ET-1,IL-8 and neutrophil percentage before surgery(T1),at the beginning of CPB(T2),at the end of CPB(T3),2h(T4),6h(T5)and 24 h after CPB(T6).The pulmonary artery and venous blood were drawed respectively before and after the cardiopulmonary bypass,and the cross-pulmonary mononuclear cell count was calculated.The collected data were statistically processed.Results:Compared with T1,the levels of IL-8,ET-1,NO and the percentage of neutrophils were increased in both groups from T2 to T6(P <0.05),as well as the levels of the transpulmonary mononuclear cells at the end of cardiopulmonary bypass.There was no significant difference between the two groups before the start of cardiopulmonary bypass(P> 0.05).The levels of IL-8,ET-1 and the percentage of neutrophils in group S were lower than those in group C(P <0.05).The level of NO in group S were significantly higher than those in group C(P <0.05).The transpulmonary mononuclear cells in group S were significantly lower than group C at the end of CPB(P<0.05).Conclusion:The application of 2% sevoflurane in the early ischemia and early reperfusion injury can reduce the inflammatory injury caused by cardiopulmonary bypass,which may be related to increasing NO,reducing ET-1,IL-8 and neutrophil production,reducing aggregation of monocytes in the lungs.