Aminophylline In Lung Injury In Rheumatic Heart Valve Replacement Surgery

[ Objective ] This study attempted to examine whether aminophylline could reduce the inflammatory response induced by CPB and improve the pulmonary function in patients undergoing valve replacement.TMethods ] Twenty patients with rheumatic heart valve disease scheduled for elective valve replacement were randomly divided into two groups of 10 each :control group and aminophylline group. In aminophylline group aminophylline (5mg/kg) was injected slowly via vein in five minutes after anesthesia induced and maintained with 0.5mg / kg h dose until the end of CPB. In control group aminophylline was replaced by same volume of lactated Ringer solution. Peripheral blood samples were taken before CPB and l,8,24h after termination of CPB, for determination of TNF-a, IL-8 and IL-10. Patients hemodynamics, RI, neutrophil cell ratio of right atrium blood to left atrium blood, plasma MDA and clinical outcomes were recorded to assess the effects of experiment.[Results] The major preoperative and intraoperative variables were comparable in the two groups. No death occurred. The TNF- a concentration was not significantly different before CPB between the two groups. But at 1,8 and 24h after CPB TNF-a level was significantlyrvhigher than the baseline value before CPB in control group and that in aminophylline group(P<0.05). The IL-8 concentration greatly increased at 1 and 8h after CPB in both groups as compared with the before CPB (PO.05), but was much lower in the aminophylline group than that in the control group (PO.05). The IL-10 concentration at Ih after CPB in the control group was significantly lower than that in aminophylline group (PO.05), but was much higher than the baseline value before CPB (P<0.05). RI at 1 and 8h after CPB in control group was higher than the baseline value before CPB and that in the aminophylline group (PO.05). Neutrophil ratio of right atrium blood to left atrium blood and plasma MDA was significantly lower at 30 min after aortic declamping in aminophylline group as compared with control group (PO.05). The time of mechanical ventilation and ICU stay were shorter in aminophylline group than in control group (PO.05). Urine volumes of 24 hours after surgery in control group were fewer than in the aminophylline group (PO.05).[ Conclusion ] Aminophylline could obviously reduce the inflammatory response induced by cardiopulmonary(CPB) and improve the pulmonary function in patients undergoing valve replacement.