Effect of autogenous oxygenator cardiopulmonary bypass on lung protection at cardiac surgery

Objective:To investigate lung injury and protective effect of autogenous oxygenator cardiopulmonary bypass(CPB) on lung after CPB.Methods:24 adult mongrels (weight 15±1kg) were randomly divided into two groups,12 for experimental group,in which the dog's own lung was used as oxygenator;12 for control group,in which the artificial lung (bubble oxygenator) was used as oxygenator.Leukocyte count of right atrium and left atrium,difference of transpulmonary leukocyte,the pulmonary artery pressure,and the oxygen pressure of artery were measured during the perioperative period.And lung biopsies were obtained before and after CPB in both groups for microscope pathological examination.Results:Autogenous oxygenator CPB technique could provide satisfactory oxygenation during CPB.The oxygen pressure after CPB was significantly higher in the experimental group than that in the control group at different time points( P 0.02).The difference of transpulmonary leukocyte after CPB was significantly lower in the experimental group than that in the control group at different time points( P 0.02).The pulmonary artery pressure was significantly lower in the experimental group than that in the control group at the 30th,60th,90th time points( P 0.02).Histologic examination of lung tissue revealed that in control group there were more obvious intraalveolar hemorrhage,leukocyte adhesion and interstitial edema compared with experimental group.Conclusion:Leukocytic chemotaxis reinforcement and leukocyte sequestration lead to lung injury. The autogenous oxygenator CPB technique can provide satisfactory oxygenation and obtain better lung protection effect.