Objective To evaluate the effect of the cardiopulmonary bypass ( CPB) on the pulmonary function in infants with or without pulmonary hypertension in congential ventricular septal defect ( VSD). Methods Twenty infants ...Objective To evaluate the effect of the cardiopulmonary bypass ( CPB) on the pulmonary function in infants with or without pulmonary hypertension in congential ventricular septal defect ( VSD). Methods Twenty infants with VSD were enrolled in the study from Jan. to Dec. 2004. They were divided into two groups: pulmonary hypertension group and non-pulmonary hypertension group, ten infants respectively. Pulmonary function parameters were measured before CPB and 3, 6, 9, 12, 15, 18, 21, 24h after CPB, the following data were recorded- duration for mechanical ventilation ( Tmv) and staying in the cardiac intensive care unit ( Tcicu) after cardiac surgery. Results Before CPB, the pulmonary function parameters in non-pulmonary hypertension group were more superior than in pulmonary hypertension group (P < 0. 01). By contraries, the pulmonary function parameters in every time stage after CPB statistically significant decreased in non-pulmonary hypertension group (P <0. 05), especially at 6, 9, and 15h after CPB (P < 0. 01). In pulmonary hypertension group, the pulmonary function parameters in 3h after CPB were more improved than before CPB, though there was no statistical significance. But they had statistically significant decreased at 9, 12, 15h after CPB (P < 0. 05). There was a similar change in pulmonary function between two groups at 21, 24h after CPB. Conclusion Exposure to CPB adversely affects pulmonary function after surgical repair of VSD in infants. We consider that the benefits of the surgical correction in infants with pulmonary hypertension outweight the negative effects of CPB on pulmonary function. We should improve cardiac function to avoid the presence of the nadir trough in pulmonary function. The infants with pulomonary hypertension also have ability to wean from mechanical ventilation as soon as possible, if the hemodynamics is stable, and without the responsive pulmonary hypertension or pulmonary hypertension crisis after surgical repair.展开更多
Objective: To identify the protective effects of hypovolemic hypotension preconditioning on cardiopulmonary function after myocardial ischemia/reperfusion injury and to explore the possible mechanism.Methods: Twenty-f...Objective: To identify the protective effects of hypovolemic hypotension preconditioning on cardiopulmonary function after myocardial ischemia/reperfusion injury and to explore the possible mechanism.Methods: Twenty-four male white rabbits were randomly assigned to two groups. In the control group, ischemia/reperfusion animals(Group I/R, n=10) were subjected to thirty-minute occlusion of left anterior descending coronary artery and two-hour reperfusion. Animals in hypovolemic hypotension preconditioning group (Group HHP, n=14) experienced brief systemic ischemia preconditioning through blood withdrawl to lower blood pressure to 40%-50% of the baseline before myocardial ischemia/reperfusion. Hemodynamic parameters were recorded. Blood sample was taken to measure superoxide dismutase (SOD), malondialdehyde (MDA) and nitrogen monoxide (NO) changes with blood gas analysis. Myocardium specimens were sampled to examine apoptosis-related gene interleukin-1 beta converting enzyme (ICE) mRNA. Results: Cardiac mechanical function and lung gas exchange remained stable in Group HHP with a significant increase in NO level; while in Group I/R without preconditioning, cardiopulmonary dysfunction was present after 2 h reperfusion associated with a significant reduction in NO formation and an increase in MDA (P<(0.001)). There was negative expression of ICE mRNA in the two groups.Conclusions: Hypovolemic hypotension preconditioning significantly improves cardiopulmonary function and increases NO formation and the protective benefit associated with hypovolemic hypotension preconditioning of the heart may be regulated through NO mediated mechanism.展开更多
文摘Objective To evaluate the effect of the cardiopulmonary bypass ( CPB) on the pulmonary function in infants with or without pulmonary hypertension in congential ventricular septal defect ( VSD). Methods Twenty infants with VSD were enrolled in the study from Jan. to Dec. 2004. They were divided into two groups: pulmonary hypertension group and non-pulmonary hypertension group, ten infants respectively. Pulmonary function parameters were measured before CPB and 3, 6, 9, 12, 15, 18, 21, 24h after CPB, the following data were recorded- duration for mechanical ventilation ( Tmv) and staying in the cardiac intensive care unit ( Tcicu) after cardiac surgery. Results Before CPB, the pulmonary function parameters in non-pulmonary hypertension group were more superior than in pulmonary hypertension group (P < 0. 01). By contraries, the pulmonary function parameters in every time stage after CPB statistically significant decreased in non-pulmonary hypertension group (P <0. 05), especially at 6, 9, and 15h after CPB (P < 0. 01). In pulmonary hypertension group, the pulmonary function parameters in 3h after CPB were more improved than before CPB, though there was no statistical significance. But they had statistically significant decreased at 9, 12, 15h after CPB (P < 0. 05). There was a similar change in pulmonary function between two groups at 21, 24h after CPB. Conclusion Exposure to CPB adversely affects pulmonary function after surgical repair of VSD in infants. We consider that the benefits of the surgical correction in infants with pulmonary hypertension outweight the negative effects of CPB on pulmonary function. We should improve cardiac function to avoid the presence of the nadir trough in pulmonary function. The infants with pulomonary hypertension also have ability to wean from mechanical ventilation as soon as possible, if the hemodynamics is stable, and without the responsive pulmonary hypertension or pulmonary hypertension crisis after surgical repair.
文摘Objective: To identify the protective effects of hypovolemic hypotension preconditioning on cardiopulmonary function after myocardial ischemia/reperfusion injury and to explore the possible mechanism.Methods: Twenty-four male white rabbits were randomly assigned to two groups. In the control group, ischemia/reperfusion animals(Group I/R, n=10) were subjected to thirty-minute occlusion of left anterior descending coronary artery and two-hour reperfusion. Animals in hypovolemic hypotension preconditioning group (Group HHP, n=14) experienced brief systemic ischemia preconditioning through blood withdrawl to lower blood pressure to 40%-50% of the baseline before myocardial ischemia/reperfusion. Hemodynamic parameters were recorded. Blood sample was taken to measure superoxide dismutase (SOD), malondialdehyde (MDA) and nitrogen monoxide (NO) changes with blood gas analysis. Myocardium specimens were sampled to examine apoptosis-related gene interleukin-1 beta converting enzyme (ICE) mRNA. Results: Cardiac mechanical function and lung gas exchange remained stable in Group HHP with a significant increase in NO level; while in Group I/R without preconditioning, cardiopulmonary dysfunction was present after 2 h reperfusion associated with a significant reduction in NO formation and an increase in MDA (P<(0.001)). There was negative expression of ICE mRNA in the two groups.Conclusions: Hypovolemic hypotension preconditioning significantly improves cardiopulmonary function and increases NO formation and the protective benefit associated with hypovolemic hypotension preconditioning of the heart may be regulated through NO mediated mechanism.
