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KMID : 0350519940470041679
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Journal of Catholic Medical College
1994 Volume.47 No. 4 p.1679 ~ p.1689
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Effect of Hemodilution Solution on Reperfusion in Ex Vivo Rabbit Lung Model
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Abstract
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Lung transplantation has been considered as a final definitive mode of surgical therapy for the patients with end-stage parenchymal and vascular lung disease. To obtain successful lung transplantation, proper preservation of lung during ischemia
and
prevention of ischemia-reperfusion lung injuries are indispensably required procedures for maintaining morphological and functional integrity of lungs.
This study designed to evaluate the possible role of diluted blood whichmay reduce reperfusion injury when it is perfusing the transplanted lung as a initial perfusate. Ex-vivo heart-lung blocs were procured from the experimental rabbits and
perfused
through pulmonary artery with modified Euro-Collins solution. After twelve hours of cold storage, heart-lung blocs were reperfused with various perfusates and divided into 3 groups according to the composition of perfusate: Group 1(n=8);
reperfusing
with preserved whole blood for 20 minutes. Group 2(n=8); reperfusing with blood by 0.9% normal saline for first 10 minutes, followed by whole blood perfusing for second 10 minutes. Group 3(n=8); reperfusing with diluted blood by modified
Euro-Collins
solution and perfusing as same maneuver as group 2.
The blood gas analysis, ratio of wet lung weight to dry lung weight and pulmonary arterial pressure as the physiological changes of lung were measured in heart lung blocs.
@ES The results were as follows:
@EN 1. Oxygen tension of left atrial effluent coming from reperfusion during initial 10 minutes reperfusion was significantly higher in group 2(99.25±13.30 mmHg) and 3(118.38±13.42 mmHg) than in group 1(53.25±4.50 mmHg). After subsequent 10
minutes
reperfusion, similar trend was observed representing 80.50±6.63 mmHg in group 2, 82.50±8.45 mmHg in group 3 and 51.63±3.78 mmHg in group 1.
2. Carbon dioxide tension of left atrial effluent in group 2(35.65±4.02mmHg) and 3 (31.20±3.18mmHg) was also significantly lower than that in group 1(45.21±7.77mmHg) after 20 minutes of reperfusion.
3. Tracheal airway pressure during initial 10 minutes reperfusion was significantlylower in group 2(3.50±0.53mmHg) and 3(4.00±0.76 mmHg) than in group 1(6.00±1.20mmHg). Airway pressure of subsequent 10 minutes reperfusion was also
significantly
lower in group 2(4.00±0.93mmHg) and 3(3.63±0.74mmHg) than in group 1(6.50±1.07mmHg).
4. Pulmonary artery pressure during initial 10 minutes reperfusion was significantly lower in group 2(17.38±3.07mmHg) and 3(14.63±3.38mmHg) than in group 1(42.50±8.80 mmHg). After subsequent 10 minutes reperfusion, measured pulmonary artery
pressure
was also significantly lower in group 2(24.63±5.80 mmHg) and 3(19.88±3.48 mmHg) than in group 1(39.00±9.53 mmHg).
5. Ratio of wet lung weight to dry lung weight was lower in group 2(6.55±0.74) and 3(6.22±0.82) than in group 1(7.12±0.47) after 20 minutes of reperfusion, however, significant difference was observed between group 3 and group 1.
Throughout these results it suggested that initial 10 minutes of hemodilute reperfusion and subsequent 10 minutes of whole blood reperfusion reduce early pulmonary ischemia-reperfusion injury by improving rheology of pulmonary circulation and
decrease
pulmonary edema in rabbit lung.
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KEYWORD
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