Protective Effect Of Hydrogen Cardioplegia On Lung Injury In Patients Undergoing Open Heart Surgery Under Cardiopulmonary Bypass

Objective:With the continuous development of cardiac surgery,cardiopulmonary bypass?CPB?technology has been quite mature,and the mortality and complications of open heart surgery under CPB have gradually decreased.However,with the aging of the population,the incidence of pulmonary complications after CPB has gradually increased.How to reduce the incidence of pulmonary complications after CPB has gradually become a hot and difficult topic in cardiac surgery research.The mild pulmonary complications were transient lung injury,while the severe ones were acute respiratory distress syndrome?ARDS?and acute respiratory failure,which endangered the life of patients and affected the prognosis.This experiment proves its clinical value by observing the protective effect of hydrogen molecule in hydrogen-containing cardioplegia on lung injury.It can minimize the lung injury caused by CPB and reduce the occurrence of ARDS,acute respiratory failure and other complications after operation.Methods:32patients with cardiac diseases hospitalized in the Department of Cardiac Surgery,Affiliated Hospital of North Sichuan Medical College from June 2018 to January 2019 were selected.All patients underwent open heart surgery under CPB.The patients were randomly divided into control group?group A?and experimental group?group B?with16 cases in each group.There were no significant differences in age,sex,height and weight,cardiac function grade and left ventricular ejection fraction between the two groups.?P>0.05?.Patients in group A were perfused with ST.Thomas II cardioplegia solution,while patients in group B were perfused with hydrogen cardioplegia solution.At T1:skin incision;T2:CPB stopping;T3:CPB stopping 2 hours;T4:CPB stopping 6 hours;T5:12hours after CPB stopping;T6:24 hours after CPB stopping,6 time points to take arterial blood to detect?PaO₂?,?PaCO₂?,and?FiO₂?were recorded to calculate the?OI?and?RI?.The plasma levels of TNF-?,IL-6,IL-8,MDA and SOD were measured by double-antibody sandwich enzyme-linked immunosorbent assay?ELISA?.The cardiopulmonary bypass time,aortic block time and cardiac resuscitation assistance were observed and recorded.Circulation time,ventilator use time after operation,incidence of pulmonary infection and hypoxemia after operation.Result:1.There were no significant differences in inflammatory factors TNF-?,IL-6,IL-8,oxidative and antioxidant indices MDA,SOD,respiratory function indices OI and RI at T1 between the two groups?P>0.05?.2.Inflammatory factors?TNF-?,IL-6,IL-8?in the two groups increased and then decreased at the time of T2-T6.The concentration of inflammatory factors in the experimental group was lower than that in the control group at the time of T2-T6?P<0.05?.3.The concentration of MDA in the two groups at T2-T6 time points increased first and then decreased,and the concentration of MDA in the experimental group was lower than that in the control group at all times of T2-T6?P<0.05?;The concentration of SOD at T2-T6 time showed a gradual downward trend,and the concentration of SOD in the experimental group was higher than that in the control group at all times of T2-T6?P<0.05?.4.There was no significant difference in OI and RI between the two groups at T1 and T2?P>0.05?.OI in the experimental group was higher than that in the control group at T3-T6?P<0.05?;RI in the T3-T6 experimental group was lower than that in the control group?P<0.05?.5.There was no significant difference in the incidence of pulmonary infection between the two groups.The incidence of hypoxemia in the experimental group was lower than that in the control group?P<0.05?.Conclusions:Hydrogen molecule in hydrogen-containing cardioplegia can inhibit the production of inflammatory factors during CPB,reduce the levels of TNF-?,IL-6 and IL-8 in plasma,have antioxidant effect,can increase plasma SOD content,reduce MDA content and neutralize toxic free radicals;Improving the oxygenation function of lung after operation and reducing the incidence of hypoxemia can alleviate lung injury caused by CPB,and has good lung protection for patients undergoing cardiac surgery under CPB,...