HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Matheis, G. Articles by Young, H. H. Search for Related Content PubMed PubMed Citation Articles by Matheis, G. Articles by Young, H. H.

The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 513-519, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Cardiopulmonary dysfunction produced by reoxygenation of immature hypoxemic animals supported by cardiopulmonary bypass. Prevention by intravenous metabolic pretreatment

G Matheis, DB Tixier, GD Buckberg, K Ihnken, K Morita, MP Sherman and HH Young
Division of Cardiothoracic Surgery, University of California, Los Angeles School of Medicine.

This study tests the hypothesis that reoxygenation injury is produced when cardiopulmonary bypass is initiated in immature hypoxemic piglets and that it causes cardiopulmonary dysfunction that can be avoided by intravenous metabolic treatment before and during cardiopulmonary bypass. Of 18 immature Yorkshire-Duroc piglets (aged < 3 weeks), six were anesthetized, instrumented, and observed for 5 hours (control animals). Twelve piglets underwent up to 2 hours of hypoxemia (arterial oxygen tension = 20 to 30 mm Hg) before initiation of reoxygenation on cardiopulmonary bypass. Six received an intravenous metabolic infusion solution (mercaptopropionyl glycine, catalase, aspartate, glutamate, glucose/insulin), which was started before and continued during cardiopulmonary bypass. Hypoxia produced an initial hyperdynamic response (39% increase in cardiac index; p < 0.05) followed by progressive hemodynamic deterioration, necessitating premature initiation of bypass in 8 of 12 hypoxemic piglets (67%). Reoxygenation- induced injury (assessed 30 minutes after cardiopulmonary bypass) was characterized by 39% reduction of stroke work index (p < 0.05), increased myocardial lipid peroxidation (79% increase of conjugated dienes; p < 0.05), 254% increase in pulmonary vascular resistance index (p < 0.05), 22% decrease in static lung compliance (p < 0.05), and 50% decrease in arterial/alveolar oxygen tension ratio (p < 0.05). These reoxygenation changes were avoided by intravenous metabolic treatment. We conclude that the reoxygenation of immature hypoxemic piglets by initiating cardiopulmonary bypass results in cardiopulmonary dysfunction that may increase vulnerability to subsequent ischemia (i.e., aortic crossclamping). The cardiopulmonary reoxygenation changes are preventable by intravenous metabolic treatment before and during cardiopulmonary bypass needed for cardiac repair.

This article has been cited by other articles:

				G. Bolotin, J. Raman, U. Williams, E. Bacha, M. Kocherginsky, and V. Jeevanandam Glutamine Improves Myocardial Function Following Ischemia-Reperfusion Injury Asian Cardiovasc Thorac Ann, December 1, 2007; 15(6): 463 - 467. [Abstract] [Full Text] [PDF]

				A. F. Corno, G. Milano, M. Samaja, P. Tozzi, and L. K. von Segesser Chronic hypoxia: A model for cyanotic congenital heart defects J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 105 - 112. [Abstract] [Full Text] [PDF]

				G Matheis, M Scholz, A Simon, O. Dzemali, and A Moritz Leukocyte filtration in cardiac surgery: a review Perfusion, September 1, 2001; 16(5): 361 - 370. [Abstract] [PDF]

				J. M. Pearl, D. P. Nelson, C. J. Wagner, J. P. Lombardi, and J. Y. Duffy Endothelin receptor blockade reduces ventricular dysfunction and injury after reoxygenation Ann. Thorac. Surg., August 1, 2001; 72(2): 565 - 570. [Abstract] [Full Text] [PDF]

				K. Ihnken, K. Morita, G. D. Buckberg, B. Winkelmann, M. Schmitt, L. J. Ignarro, M.P. Sherman, and K. Ihnken Nitric-Oxide-Induced Reoxygenation Injury in the Cyanotic Immature Heart Is Prevented by Controlling Oxygen Content During Initial Reoxygenation Angiology, March 1, 1997; 48(3): 189 - 202. [Abstract] [PDF]