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Ann Thorac Surg 1993;55:1147-1152
© 1993 The Society of Thoracic Surgeons

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Articles

Increased lung injury in pulmonary hypertensive patients during open heart operations

Department of Cardiovascular Surgery and Clinical Laboratory, National Cardiovascular Conter, Osaka, Japan

Accepted for publication August 3, 1992.

^_* Address reprint requests to Dr Yamamoto, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565, Japan.

To investigate lung injury in adult open heart operations during extracorporeal circulation, we measured plasma chemiluminescence levels. Nineteen patients were divided into two groups depending on preoperative pulmonary artery pressure: a pulmonary hypertension group (n = 11) and a control group (n = 8). Plasma samples were taken simultaneously from arterial and central venous lines at six different points during and early after operation. Arteriovenous difference of chemiluminescence (counts/10 seconds) increased significantly only in the pulmonary hypertension group (from –19.1 ± 8.3 at the end of cross-clamping to 23.7 ± 12.4 at the end of bypass; p < 0.01). There was a positive correlation between peak values of arterial plasma chemiluminescence and postoperative respiratory index in the pulmonary hypertension group (p < 0.05). In addition, during the first 12 hours postoperatively, arteriovenous difference of chemiluminescence in the pulmonary hypertension group changed significantly from negative to positive values (p < 0.05). These data suggest that free radical activity (detected by chemiluminescence) was deeply involved in lung injury during and also early after open heart operations, especially in pulmonary hypertensive patients.

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