Acute lung injury during cardiopulmonary bypass. Are the neutrophils responsible?

Détails

ID Serval
serval:BIB_9312D00C9F75
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Acute lung injury during cardiopulmonary bypass. Are the neutrophils responsible?
Périodique
Chest
Auteur(s)
Tonz  M., Mihaljevic  T., von Segesser  L. K., Fehr  J., Schmid  E. R., Turina  M. I.
ISSN
0012-3692
Statut éditorial
Publié
Date de publication
12/1995
Peer-reviewed
Oui
Volume
108
Numéro
6
Pages
1551-6
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Dec
Résumé
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, rectal temperature: 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 (R2 = 0.5, p = 0.002 and R2 = 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.
Mots-clé
Body Temperature Cardiopulmonary Bypass/*adverse effects Female Humans Leukocyte Count Leukocyte Elastase Male Middle Aged Neutrophils/*physiology Pancreatic Elastase/blood Respiratory Distress Syndrome, Adult/blood/*etiology/physiopathology Respiratory Mechanics
Pubmed
Web of science
Création de la notice
14/02/2008 15:17
Dernière modification de la notice
03/03/2018 19:33
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