| Objective To investigate the effects of different dosage of Mucosolvin on lung protection under open heart operation of children.Methods Thirty-six ASA II-III children scheduled for repair of VSD were randomly divided into control(group C), Mucosolvin l(group M1, 2.25mg/kg) and Mucosolvin 2(group M2, 4.50mg/kg) group with 12 cases each. Mucosolvin was infused slowly after skin incision in group M1 or M2, and same volume of saline as that in group M1 or M2 was insteaded of Mucosolvin in group C. Blood samples were taken from artery before skin incision (T1), at 20 min after CPB(T2), 20 min after aortic unclamping(T3), 2h(T4), 6h(T5) after termination of CPB, 12 h(T6) after operation for determination of plasma MMP-9, TNF-α, MDA concentration and SOD activity and blood gas analysis. Fraction of inspired oxygen(FiO2), tidal volume(VT) and airway pressure (Pmax, Pmin) was recorded from anesthesia machine or breathing machine. Respiratory index (RI) was calculated at T1, T4, T5 and T6. Pulmonary compliance(CL) was calculated at T1 and T4.Results 1. There were no significant differences in the levels of MMP-9, TNF-α, MDA, SOD, RI and CL at T1 among the three groups (P > 0.05).2. The levels of MMP-9 all increased during or after CPB (P < 0.01). The levels of MMP-9 at T2～T5 in group M2 were lower than that in group C and group M1(P < 0.01～0.05), whereas there were no significant differences not only between group M1 and group C but also between group M2 and group M1 (P > 0.05).3. The levels of TNF-αat T2～T5 in group M2 and group C were higher than T1 (P< 0.01), whereas that at T2～T6 in group M1 also increased (P< 0.01).The levels of TNF-αat T2～T6 in group M2 were lower than that in group C and group M1 (P < 0.01), whereas the level in group M1 being significantly lower than group C was only at T6(P < 0.05).4. The levels of MDA at T2～T6 in the three groups were all higher than T1 (P < 0.01). The levels of MDA at T2～T6 in group M2 were lower than that in group C and group M1 ( P < 0.01), at the same time there were no significant differences between group M1 and group C (P > 0.05)5. The levels of SOD at T2～T4 in group C increased significantly than T1(P < 0.01), whereas that at T2～T5 in group M1 and group M2 also increased ( P < 0.01～0.05). The levels of SOD at T2～T6 in group M2 were lower than that in group C (P < 0.01～0.05), at the same time the levels of SOD at T3～T4 in group M2 were lower than that in group M1 (P < 0.01), whereas there were no significant differences between group M1 and group C (P > 0.05).6. The levels of RI at T4～T6 in group C and M1 increased significantly than T1 (P < 0.01), whereas that in group M2 was only higher than T1 at T4( P < 0.05). The levels of RI at T4～T6 in group M2 were lower than that in group C and group M1 (P < 0.05), at the same time there were no significant differences between group M1 and group C (P>0.05) .7. The levels of CL at T4 in the three groups all increased significantly than T1 (P < 0.01). The levels of CL at T4～T6 in group M2 were higher than that in group C (P < 0.05), whereas there were no significant differences not only between group M1 and group C but also between group M2 and group M1 (P > 0.05). Conclusion CPB can cause systemic inflammatory response syndrome and ischemia-reperfusion injury of the lung and descend pulmonary function. Some dosage of Mucosolvin can restrain inflammatory reaction and oxidative stress caused by CPB, accordingly perform lung protection during CPB. Lung protection of Mucosolvin for children during CPB also shows the characteristic of dose dependent: common dosage (2.25mg/kg) have no effect of lung protection, otherwise medium dosage (4.50mg/kg) can perform the effect to some extent.
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