Continuous perfusion of pulmonary arteries during total cardiopulmonary bypass favorably affects levels of circulating adhesion molecules and lung function

AbstractObjectives: Lung injury is a serious complication of cardiopulmonary bypass in infants with congenital heart disease and pulmonary hypertension. Cessation of blood flow in the pulmonary arteries during cardiopulmonary bypass is known to provoke lung dysfunction. We assessed the effect of continuous pulmonary perfusion on circulating adhesion molecules and on lung function. Methods: Fourteen infants with congenital heart disease and pulmonary hypertension were enrolled in the study. During total cardiopulmonary bypass, 8 patients underwent continuous perfusion of the pulmonary arteries (perfusion group), and the remaining 6 patients did not (control group). Plasma levels of circulating intercellular adhesion molecule 1, soluble granule membrane protein 140, and sialyl Lewisx and PaO2/fraction of inspired oxygen ratios were measured before commencement and serially for 24 hours after termination of bypass. Results: Plasma levels of circulating intercellular adhesion molecule 1 decreased significantly at the termination of bypass in both groups but returned to prebypass levels immediately in the control group, whereas in the perfusion group the values remained significantly less than those before bypass. Plasma levels of soluble granule membrane protein 140 in the control group were significantly higher at 6 and 12 hours after bypass than levels before bypass, whereas in the perfusion group the values remained at the prebypass level throughout the postbypass period. Trends of plasma levels of sialyl Lewisx were alike in both groups. PaO2/fraction of inspired oxygen ratios in the control group decreased significantly from 6 hours after bypass, whereas values in the perfusion group remained at the prebypass value throughout the postbypass period. Conclusions: This study suggests that in infants having congenital heart disease and pulmonary hypertension, continuous pulmonary perfusion during total cardiopulmonary bypass minimizes ischemic insult and neutrophil-endothelial interaction mediated by adhesion molecules in the pulmonary microvessels.J Thorac Cardiovasc Surg 2001;122:242-

Rapidly Progressive Pancytopenia, Hepatomegaly, and Abnormal Lung Uptake of Colloid in Systemic Lupus Erythematosus: Possible Saturation of Reticuloendothelial System with Blood Elements

A patient with systemic lupus erythematosus developed severe abdominal pain and tender hepatomegaly associated with progressive pancytopenia and elevated serum levels of circulating immune complexes. Liver scintigram demonstrated extreme hepatomegaly with poor colloid uptake and splenomegaly with increased colloid uptake. An unusual accumulation of colloid in the lungs was also noted. Subsequent clinical and laboratory studies raised the possibility of saturation of the reticuloendothelial system in the liver by circulating immune complexes and blood cells, a condition demonstrated in experimental animals, but not hitherto well documented in the human immune complex disorder

Mechanobiological Signal Transduction in Differentiating Chondrocyte and New Configuration for Mechanical Stress Culture

Proceedings of the 2nd IEEE International Conference on Nano/Micro Engineered and Molecular Systems, January 16 - 19, 2007, Bangkok, Thailan