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Korean J Crit Care Med > Volume 19(2); 2004 > Article
Korean Journal of Critical Care Medicine 2004;19(2): 98-105.
원저 : 심폐회로 충진액의 동종혈액이 장점막 허혈 및 폐부종에 미치는 영향
홍성진, 문세호, 성춘호, 이해진, 최진환, 이지영, 김용석
가톨릭대학교 의과대학 마취통증의학교실
The Effect of Blood Transfusion on the Tissue Perfusion and Lung Injury during Cardiopulmonary Bypass
Sung Jin Hong, Se Ho Moon, Choon Ho Sung, Hae Jin Lee, Jin Hwan Choi, Ji Young Lee, Yong Suk Kim
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. hongs@catholic.ac.kr
BACKGROUND: The blood components of priming solution for cardiopulmonary bypass (CPB) may have opposite roles for tissue perfusion, which are the activation of inflammatory reaction and the improvement of oxygen carrying capacity. This study is aimed to investigate the effect of blood transfusion of priming solution on inflammatory response and tissue perfusion. METHODS: Twenty mongrel dogs randomly allocated and received hypothermic CPB with blood- containing (H group, n=10), or non-hemic (NH group, n=10) priming solution. Gastric intramucosal CO2 concentration (PrCO2), intramucosal pH (pHi), interleukin-8 (IL-8), blood gas and hemodynamic parameters were measured at 1) before CPB, 2) 1 hour during CPB, 3) the end of CPB, 4) 2 hours after CPB, 5) 4 hours after CPB. The ratio of wet to dried lung weight was measured. Statistical verification was performed using repeated measures ANOVA and unpaired t-test. RESULTS: PrCO2 increased and pHi decreased during the study without significant difference between the groups. IL-8 increased in both groups and IL-8 of H group increased higher than that of NH group during the study. The difference between PaCO2 and end-tidal CO2 of NH group was higher than that of H group at 4 hours after CPB. The ratio of wet to dried lung weight was not significantly different between the groups. CONCLUSIONS: We conclude that the allogenic blood in priming solution aggravates the CPB- induced inflammatory reaction, however, the CPB-induced impairment of gastric mucosal perfusion and the pulmonary edema are not significantly affected, compared to non-hemic solution.
Key Words: Blood-containing priming solution; Cardiopulmonary bypass; Gastric intramucosal pHi; Interleukin-8; Lung injury; Non-hemic priming solution
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