Altered reactivity to acetylcholine in the pulmonary circulation after cardiopulmonary bypass is part of reperfusion injury

Journal of Clinical Anesthesia
Monika AngdinJ Liska

Abstract

To investigate whether a time sequence of acetylcholine (ACH) reactivity indicative of endothelial reperfusion injury could be demonstrated in the pulmonary circulation in patients after cardiopulmonary bypass (CPB). Prospective study. Operating theater and intensive care unit of a university hospital. 10 ASA physical status III and IV patients with ischemic or valvular heart disease. Pulmonary vascular resistance index (PVRI) was measured before and during an infusion of ACH. This procedure was done after induction of anesthesia but before surgery, immediately after weaning from bypass, and at 1 to 1.5 and 4 hours after CPB. ACH caused a decrease in PVRI before (p < 0.01) and directly after CPB (p < 0.05) but not at 1 to 1.5 or 4 hours after bypass. The maintained reactivity to ACH directly after CPB, followed by no reaction at 1 to 1.5 and 4 hours, was in agreement with experimental findings and indicates endothelial reperfusion injury caused by the period with no blood flow through the pulmonary artery during CPB and subsequent reperfusion.

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Citations

Jun 27, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Monika AngdinJarle Vaage
Apr 13, 2001·Acta Anaesthesiologica Scandinavica·M AngdinR Astudillo
Jul 26, 2002·Acta Anaesthesiologica Scandinavica·M Glavind-KristensenV E Hjortdal
Nov 26, 2013·Scandinavian Journal of Clinical and Laboratory Investigation·Vesa ToikkanenAri Mennander
Apr 2, 2016·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·V ToikkanenA Mennander
Apr 10, 2018·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·V ToikkanenA A Mennander
Apr 6, 2002·Journal of Wound Care·R F OienA Håkansson
Oct 1, 2009·British Journal of Midwifery·Annie HughesSherryl H Goodman

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