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Ann Thorac Surg 1996;62:1580-1586
© 1996 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

L-Arginine Administration During Reperfusion Improves Pulmonary Function

Division of Cardiothoracic Surgery, University of California, Los Angeles, Medical Center, Los Angeles, California

Background. Nitric oxide is crucial to the maintenance of vascular homeostasis. Because nitric oxide levels decline upon lung reperfusion, infusion of L-arginine, a nitric oxide precursor, during reperfusion might prove effective at ameliorating reperfusion injury.

Methods. Neonatal piglet heart-lung blocks were preserved with Euro-Collins solution for 12 hours, rewarmed at room temperature for 1 hour, and reperfused for 10 minutes with either whole blood (n = 5), whole blood containing L-arginine (10 mmol/L; n = 6), or leukocyte-depleted blood (n = 6) on an isolated, blood-perfused, working heart-lung circuit. After the initial 10 minutes, all blocks received whole blood for 4 hours. Control blocks were continuously perfused on the circuit without intervening ischemia (n = 6).

Results. The partial pressure of oxygen in the whole blood group (113.8 ± 33.1 mm Hg) was significantly less than in controls (417.3 ± 6.2 mm Hg; p < 0.01). Lung compliance was significantly less in the whole blood group (0.8 ± 0.2 mL/cm H₂O) than in controls (2.9 ± 0.4 mL/cm H₂O; p < 0.01). The L-arginine and leukocyte-depleted blood groups showed no significant difference from controls.

Conclusions. L-Arginine infusion during reperfusion improves pulmonary function, making it a simple alternative to leukocyte depletion.

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Discussion
Ann. Thorac. Surg. 1996 62: 1586. [Extract] [Full Text]

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