High-dose Methylprednisolone Affects Pulmonary Surfactant before and after Cardiopulmonary Bypass Article Abstract
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Published: January 20, 2006
To study whether Pulmonary Surfactant', 1, 1595216)"; href="/tags/pulmonary-surfactant/">pulmonary surfactant would change after cardiopulmonary bypass(CPB)and whether high-dose methylprednisolone would affect pulmonary Surfactant before and after CPB. Twenty-one six-week-old 'Large White' male pigs,with average weight of(14.4±0.7)kg,were divided into 3 groups:the Control group(G1,n=6),the CPB group(G2,n=9),and the MP + CPB group(G3,n=6).In G1,all young animals underwent a 'sham' procedure of CPB.After intubation and sternal incision,all young pigs were heparinized for 120 min.Then protamine was given and the operation was ended in 180 min.In G2 and G3,after intubation and sternal incision,CPB was established with aortic clamping time 100 min and total CPB time 120 minutes.Then CPB was completed and protamine was given,and the operation was ended in 180 min.In G3,animals also received methylprednisolone dosed 30 mg/kg intramuscularly both 8 h and 1.5 hours before CPB.Among all animals,bronchoalveolar lavage fluid(BALF)collection was performed with a flexible pediatric fiberoptic bronchoscope inserted into a wedged position in a subsegment of different lobes before CPB,60 min afters CPB beginning,120 min after CPB beginning,and 180 min after CPB completion.The surfactant protein A(SP-A),total protein,phospholipids,saturate phosphatidylcholine,phospholipid in large aggregate(LA)and in small aggregate(SA),hemoglobin in BALF samples were tested. SP-A in G3 was more increased than those in G1 and in G2(P< 0.05).In G2,SP-A levels at CPB 120 min and post-CPB 180 min were obviously lower than that before CPB;SP-A level at post-CPB 180 min was higher than that at CPB 120 min(P< 0.05).In G2,total protein level at post-CPB 180 min was higher than those before CPB and at CPB 120 min(P< 0.05).Phospholipid levels in G2 and in G3 were significantly higher than that in G1(P< 0.05).In G2,phospholipid level at CPB 120 min was higher than others(P< 0.05).There was no significant difference of satuate phosphatidylcholine level between every group and every time point of each group.SA/LA in G2 was significantly higher than in G1 and G3(P< 0.05).Hemoglobin level in G2 was significantly higher than those in G1 and G3(P<0.05).In G2,hemoglobin levels after CPB beginning were significantly higher than before CPB.At CPB 120 min and post-CPB 180 min,hemoglobin level were higher than that at CPB 60 min(P< 0.05).Cardiopulmonary bypss will have disadvantage infection on pulmonary surfactant.High-dose methylprednisolone can make the level of surfactant protein A higher.High-dose methylprednisolone used before CPB can protect pulmonary surfactant.
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