Continuous Pulmonary Artery Perfusion With Oxygenated Warm Blood Contain Methylprednisolone Effect On Lung Injury After Cardiopulmonary Bypass

Objective:To study the effect of continous pulmonary artery perfusion with oxygeneated biood on lung injury during cardiopulmonary bypass(CPB).And to evaluate the protective effect of Methylprednisolone on lungs from acute injury induced by CPB in order to mechanism of protective of Methylprednisolone on lungs.Methods:Forty five cases undergoing valve replacement were randomly divided into 3 groups:groupâ… ,as control(n=15);groupâ…¡,receiving lung perfusion(n=15);groupâ…¢,receiving lung perfusion and Methylprednisolone(n=15).The cases in groupâ… were performed the routine procedure of CPB and mechanical ventilation.The cases in groupâ…¡were perfused with oxygenated blood continuously to thepulmonary artery during CPB and mechanical ventilation.The cases in groupâ…¢were perfused with oxygenated blood and Methylprednisolone(5mg/kg)continuously to the pulmonary artery during CPB and mechanical ventilation.supervison of anaesthetic machine before and after blocking the cavat vein:tidal volume(Vt)5ml/kg,frequency 12 bpm,FiO₂ 100%,PEEP 5cmh₂O, superrvison of anaestefic machine during blocking the caval vein:Vt 5ml/kg,frequency 12 bpm,FiO₂ 100%,PEEP 5cmh₂O.superrvison after back to ICU:Vt 10ml/kg,frequency 12 bpm,FiO₂ 50%,PEEP 5cmh₂O.Blood samples were drawn from the radial artery at the following time points:after anaesthesia,1 hours after opening aorta,being taken back to ICU 0,6,12,24 hpurs.The plasma levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)and interleukin-10(IL-10).Result:1.All the patients were recovery.2. The difference of TNF-α,IL-6 in groupâ…¡and groupâ…¢were less than in groupâ… (P＜0.05),The difference of TNF-α,IL-6 in groupâ…¢were less than in groupâ…¡.The difference of IL-10 in groupâ…¡and groupâ…¢were more than in groupâ… (P＜0.05),and the highest in groupâ…¢.Conclusion:Continuous pulmonary artery perfusion with oxygenated blood during CPB demonstrates the protection of lung vascular endothelial cell.Methylprednisolone can provide protective effects on lung injury induced by CPB.