ACUTE LUNG INJURY DURING CARDIOPULMONARY BYPASS - ARE THE NEUTROPHILS RESPONSIBLE

被引：105

作者：

TONZ, M

MIHALJEVIC, T

VONSEGESSER, LK

FEHR, J

SCHMID, ER

TURINA, MI

机构：

[1] UNIV ZURICH HOSP,CARDIOVASC SURG CLIN,CH-8091 ZURICH,SWITZERLAND

[2] UNIV ZURICH HOSP,INST ANAESTHESIOL,CH-8091 ZURICH,SWITZERLAND

[3] UNIV ZURICH HOSP,DEPT INTERNAL MED,CH-8091 ZURICH,SWITZERLAND

来源：

CHEST | 1995年 / 108卷 / 06期

关键词：

CARDIOPULMONARY BYPASS; LEUKOCYTE ACTIVATION; LUNG INJURY;

D O I：

10.1378/chest.108.6.1551

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

To test the hypothesis that acute lung injury during cardiopulmonary bypass (CPB) is related to the activation of neutrophils and the body temperature during bypass, we determined the differential WBC count, plasma elastase concentrations, and lung function before, during, and after CPB in 38 patients undergoing elective coronary artery bypass surgery, The patients were randomly assigned to receive either normothermic (n=19, rectaltemperature: 35.9 +/- 0.1 degrees C, mean +/- SE) or hypothermic (n=19, 29.2+/-0.5 degrees C) CPB, The cellular response to the extracorporeal circulation was significantly delayed in the hypothermic group with a later onset of neutrophilia and a later increase in plasma elastase levels during bypass, Lung function deteriorated significantly after CPB as assessed by respiratory index, alveolar-arterial oxygen gradient, and intrapulmonary shunt, independent of bypass temperature, There was a positive correlation between peak elastase concentrations and postoperative respiratory index as well as intrapulmonary shunt (R(2)=0.5, p=0.002 and R(2)=0.45, p=0.003, respectively), Besides peak plasma elastase levels, multiple regression revealed no significant influence of other independent factors on postoperative lung dysfunction in our patients.

引用

页码：1551 / 1556

页数：6

共 29 条

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