Effect of bronchial artery blood flow on cardiopulmonary bypass-induced lung injury

Jeffrey M. Dodd-O, Laura E. Welsh, Jorge D. Salazar, Peter L. Walinsky, Eric A. Peck, Jay G. Shake, David J. Caparrelli, Brian T. Bethea, Stephen M. Cattaneo, William A. Baumgartner, David B. Pearse

Research output: Contribution to journalArticle

Abstract

Cardiovascular surgery requiring cardiopulmonary bypass (CPB) is frequently complicated by postoperative lung injury. Bronchial artery (BA) blood flow has been hypothesized to attenuate this injury. The purpose of the present study was to determine the effect of BA blood flow on CPB-induced lung injury in anesthetized pigs. In eight pigs (BA ligated) the BA was ligated, whereas in six pigs (BA patent) the BA was identified but left intact. Warm (37°C) CPB was then performed in all pigs with complete occlusion of the pulmonary artery and deflated lungs to maximize lung injury. BA ligation significantly exacerbated nearly all aspects of pulmonary function beginning at 5 min post-CPB. At 25 min, BA-ligated pigs had a lower arterial Po2 at a fraction of inspired oxygen of 1.0 (52 ± 5 vs. 312 ± 58 mmHg) and greater peak tracheal pressure (39 ± 6 vs. 15 ± 4 mmHg), pulmonary vascular resistance (11 ± 1 vs. 6 ± 1 mmHg·l -1·min), plasma TNF-α (1.2 ± 0.60 vs. 0.59 ± 0.092 ng/ml), extravascular lung water (11.7 ± 1.2 vs. 7.7 ± 0.5 ml/g blood-free dry weight), and pulmonary vascular protein permeability, as assessed by a decreased reflection coefficient for albumin (σalb; 0.53 ± 0.1 vs. 0.82 ± 0.05). There was a negative correlation (R = 0.95, P < 0.001) between σalb and the 25-min plasma TNF-α concentration. These results suggest that a severe decrease in BA blood flow during and after warm CPB causes increased pulmonary vascular permeability, edema formation, cytokine production, and severe arterial hypoxemia secondary to intrapulmonary shunt.

Original languageEnglish (US)
Pages (from-to)H693-H700
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume286
Issue number2 55-2
StatePublished - Feb 1 2004

Keywords

  • Extracorporeal perfusion
  • Interleukin-6
  • Ischemia
  • Pig
  • Pulmonary edema
  • Reflection coefficient
  • Tumor necrosis factor-α

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • Cite this

    Dodd-O, J. M., Welsh, L. E., Salazar, J. D., Walinsky, P. L., Peck, E. A., Shake, J. G., Caparrelli, D. J., Bethea, B. T., Cattaneo, S. M., Baumgartner, W. A., & Pearse, D. B. (2004). Effect of bronchial artery blood flow on cardiopulmonary bypass-induced lung injury. American Journal of Physiology - Heart and Circulatory Physiology, 286(2 55-2), H693-H700.