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

This Article Full Text Full Text (PDF) 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 Griese, M. Articles by Rinker, C. Search for Related Content PubMed PubMed Citation Articles by Griese, M. Articles by Rinker, C.

J Thorac Cardiovasc Surg 1999;118:237-244
© 1999 Mosby, Inc.

SURGERY FOR CONGENITAL CARDIOVASCULAR DISEASE

CARDIOPULMONARY BYPASS REDUCES PULMONARY SURFACTANT ACTIVITY IN INFANTS

From Kinderklinik and Kinderpoliklinik im Dr von Haunerschen Kinderspital, Ludwig-Maximilians-University, Munich, Germany.

Address for reprints: Matthias Griese, MD, The Lung Research Group, Kinderklinik and Kinderpoliklinik im Dr von Haunerschen Kinderspital, Ludwig-Maximilians-University, Pettenkoferstr 8a, D-80336 Munich, Germany.

Objective: Infants younger than 1 year of age undergoing cardiopulmonary bypass surgery often have severe lung injury necessitating increased postoperative respiratory mechanical support. Inasmuch as the mechanisms may involve an impairment of the pulmonary surfactant system, our aim was to determine whether changes of surfactant occur in such infants.
Methods: From the day of the operation to day 7 after the operation, serial tracheobronchial small-volume lavages of 19 infants (aged 166 ± 29 days) were fractionated into a small and a large surfactant aggregate fraction and compared with those of 13 infants without lung disease (aged 203 ± 33 days).
Results: After cardiac operations with cardiopulmonary bypass surgery, total protein in lavages was increased 3-fold to 4-fold and decreased linearly with time. Surfactant protein A was increased on day 1 and day 2 and then decreased, whereas surfactant protein B and total phospholipids were increased on day 1. The ratio of phospholipids in small and large surfactant fractions was unchanged, but the surface activity of the large-aggregate surfactant was impaired on days 1 to 3.
Conclusions: Lung injury in infants after cardiopulmonary bypass surgery involves significant biochemical and functional disturbances of the pulmonary surfactant system. Inasmuch as substitution with natural surfactant might correct these deficiencies, the potential of this approach to reduce postoperative morbidity needs to be investigated.

This article has been cited by other articles:

				M. Ando, T. Murai, and Y. Takahashi The effect of sivelestat sodium on post-cardiopulmonary bypass acute lung injury in a neonatal piglet model Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 785 - 788. [Abstract] [Full Text] [PDF]

				Y. Yang, J. Cai, S. Wang, H. Zhang, J. Liu, Z. Xu, and Z. Su Better protection of pulmonary surfactant integrity with deep hypothermia and circulatory arrest. Ann. Thorac. Surg., July 1, 2006; 82(1): 131 - 136. [Abstract] [Full Text] [PDF]

				S. C Clark Lung Injury after Cardiopulmonary Bypass Perfusion, July 1, 2006; 21(4): 225 - 228. [Abstract] [PDF]

				D. J. Kozik and J. S. Tweddell Characterizing the Inflammatory Response to Cardiopulmonary Bypass in Children Ann. Thorac. Surg., June 1, 2006; 81(6): S2347 - S2354. [Abstract] [Full Text] [PDF]

				A. M. Ades and G. Wernovsky Management Considerations and Outcomes of Low-birthweight Infants Who Have Congenital Heart Disease NeoReviews, July 1, 2005; 6(7): e332 - e338. [Full Text] [PDF]

				H. Imura, H. P. Duncan, A. P. Corfield, N. Myerscough, M. Caputo, G. D. Angelini, A. R. Wolf, and A. J. Henderson Increased airway mucins after cardiopulmonary bypass associated with postoperative respiratory complications in children J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 963 - 969. [Abstract] [Full Text] [PDF]

				S. M. Bradley, J. M. Simsic, and A. M. Atz Hemodynamic effects of inspired carbon dioxide after the Norwood procedure Ann. Thorac. Surg., December 1, 2001; 72(6): 2088 - 2093. [Abstract] [Full Text] [PDF]