J Korean Med Sci.  2006 Feb;21(1):25-29. 10.3346/jkms.2006.21.1.25.

Aprotinin Attenuates the Elevation of Pulmonary Vascular Resistance After Cardiopulmonary Bypass

Affiliations
  • 1Division of Pediatric Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. tjyun@amc.seoul.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Seoul National University, College of Medicine, Seoul, Korea.

Abstract

Pulmonary vascular resistance (PVR) is generally believed to be elevated after cardiopulmonary bypass (CPB) due to whole body inflammation. Aprotinin has an antiinflammatory action, and it was hypothesized that aprotinin would attenuate the PVR increase induced by CPB. Ten mongrel dogs were placed under moderately hypothermic CPB for 2 hr. The experimental animals were divided into a control group (n=5, group I) and an aprotinin group (n=5, group II). In group II, aprotinin was administered during pre-bypass (50,000 KIU/kg) and post-bypass (10,000 KIU/kg) periods. Additional aprotinin (50,000 KIU/kg) was mixed in CPB priming solution. PVRs at pre-bypass and post-bypass 0, 1, 2, 3 hr were calculated, and lung tissue was obtained after the experiment. Post-bypass PVRs were significantly higher than prebypass levels in all animals (n=10, p<0.001). PVR elevation in group II was less than in group I at 3 hr post-bypass (p=0.0047). Water content of the lung was lower in group II (74+/-9.4%) compared to that of group I (83+/-9.5%), but the difference did not reach significance (p=0.076). Pathological examination showed a near normal lung structure in group II, whereas various inflammatory reactions were observed in group I. We concluded that aprotinin may attenuate CPB-induced PVR elevation through its anti-inflammatory effect.

Keyword

Aprotinin; Cardiopulmonary Bypass; Pulmonary Vascular Resistance; Vascular Resistance

MeSH Terms

Animals
Aprotinin/*pharmacology
*Cardiopulmonary Bypass
Comparative Study
Dogs
Hemostatics/pharmacology
Lung/*blood supply/metabolism/pathology
Male
Models, Animal
Research Support, Non-U.S. Gov't
Vascular Resistance/*drug effects
Water/metabolism
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