Comparative study of the protective effect using hypothermic cardiopulmonary bypass and normothermic cardiopulmonary bypass

Objective To explore the detrimental influence of normothermic and hypothermic cardiopulmonary bypass during open-heart surgery on immunity function,cytokines and complements.Methods Forty patients with congenital or rheumatic heart disease were randomized to receive the two strategies:normothermic CPB(study group)and hypothermic CPB(control group),20 cases in each group.Venous blood samples were collected at each time points of preoperation,end of CPB,day 1,4,7,14 postoperatively to examine the plasma level of IL-2,TNF-α,C3,C4,IgG,IgM,IgA,CD3,CD4,CD8.Results IL-2 in both groups decreased significantly at day 1,4,and returned to normal at day 7 postoperatively.IL-2 in control group was significantly lower than that in study group postoperatively.TNF-α in two groups was all higher at time points of end of CPB,day 1,4 postoperatively;in study group,it returned to normal level at day 7 postoperatively,whereas in control group,it was still higher at day 7 postoperatively than that before operation,and returned to normal at day 14 postoperatively.C3 in study group was significantly lower at time points of end of CPB,day 1,7 postoperatively than that in control group;C3 in both groups was all higher at time points of end of CPB,day 1,4 postoperatively;in study group,it returned to normal level at day 7 postoperatively,whereas in control group,it was still higher at day 7 postoperatively than that before operation and returned to normal at day 14 postoperatively.C4 in study group at time points of end of CPB,day 1 postoperatively was significantly lower than that in control group;C4 in both groups was all lower at time points of end of CPB,day 1,4 postoperatively than that before operation.The results showed that IgA after operation in both groups was significantly lower than that before operation,and returned to normal at day 7 postoperatively;IgA in study group at day 1 postoperatively was higher than that in control group.IgG in both group at time points of end of CPB,day 1,4 postoperatively was significantly lower than that before operation.IgG in control group was significantly higher at time points of end of CPB,day 1,4 postoperatively was significantly higher than that in control group.IgM in study group was significantly lower at time points of end of CPB,day 1,4 postoperatively.In control group,IgM was significantly lower at time points of end of CPB,day 1,4,7 postoperatively and returned to normal at day 14 postoperatively.IgM in study group was significantly higher at day 1,4 postoperatively than that in control group.CD3,CD4 in both groups decreased significantly at time points of end of CPB,day 1,4,and CD3、CD4 in study group and CD3 in control group returned to normal at day 7 postoperatively,CD4 in control group still lower than that before operation at day 7 postoperatively,and returned to normal at day 14 postoperatively.CD3,CD4 in control group was significantly lower at time points of end of CPB,day 1,4 than that in study group.CD8 in both groups increased significantly at day 1 postoperatively;there was no significant difference between the two groups.Conclusions The detrimental influence of open-heart surgery under normothermic CPB on humoral and cellular immunity function,cytokines and complements is less than that under hypothermic CPB,so normothermic CPB is beneficial for the postoperative recovery and anti-inflammation function.

A new rabbit model for study of lung preservation

In 1983,Cooper successfully performed the first case of right lung transplantation for a patient with end stage pulmonary fibrosis and long survival was achieved,which confirmed that lung transplantation is feasible clinically.The efficient lung transplantation has become the only hope for patients with end stage lung disease since.It′s crucial for the success of lung transplantation that the harvest and protection of the donor′s lung prior to transplantation.The preservation of donor′s lung is key for the function after lung transplantation.Apart from hypothermic approach,the perfusion procedure and the perfusion solution itself are also very important.The aim of this study was to establish an animal model,which could identify the effectiveness of preservation solution that could minimize the disturbance of the non-experimental factors so as to find the better preservation solution for lung protection.