Protective effect of nicardipine against pulmonary ischemia-reperfuston injury in patients undergoing cardiac valve replacement
- VernacularTitle:尼卡地平对心脏瓣膜置换术病人肺缺血/再灌注损伤的保护作用
- Author:
Tianlong WANG
;
Lan GAO
;
Baxian YANG
- Publication Type:Journal Article
- Keywords:
Nicardipine;
Cardiopulmonary bypass;
Lung;
Reperfusion Injury
- From:
Chinese Journal of Anesthesiology
1996;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the influence of pulmonary ischemia-reperfusion (I/R) induced by cardio-pulmonary bypass (CPB) on pulmonary function and the preventive effect of nicardipine.Methods Sixteen patients scheduled for cardiac valve replacement were randomly divided into two groups : control group ( n = 8) and nicardipine group ( n = 8) . In nicardipine group nicardipine 0.02 mg kg-1 was given at the beginning of CPB; while in control group normal saline was given instead of nicardipine. All patients were operated upon under TIVA with large doses of fentanyl. Swan-Ganz catheter was placed via internal jugular vein after induction of anesthesia. Mean pulmonary arterial pressure (MPAP), pulmonary vascular resistance index (PVRI) and lung compliance were measured and calculated before CPB (T0 ), 5min after declamping of vena cava (T1 ), at tennination of CPB (T2) and at the end of operation (T3 ). At the same time points arterial and mixed venous blood samples were taken for determination of TNF-a, SOD and LPO concentrations and polymorphonuclear leukocyte (PMN) count, intrapulmonary PMN trapping (PMNa-PMNv) and blood gases and calculation of PaO2/FiO2 , P(A-2,)O2 difference and Qs/Qt. The vena cava cross-clamping time was defined as pulmonary ischemia time. Results (1) In control group MPAP, PVRI, PaO2/FiO2 and Qs/Qt were significantly deteriorating after vena cava declamping (T1-T3) as compared with the baseline valves (T0) (P
