Ann Thorac Surg 2001;72:1892-1897
© 2001 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Helsinki, Finland
b Department of Anesthesiology, Helsinki University Central Hospital, Helsinki, Finland
Accepted for publication July 30, 2001.
* Address reprint requests to Dr Vainikka, Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 00029 HUS/Helsinki, Finland
Background. Increased pulmonary vascular resistance (PVR) and decreased arterial oxygenation frequently complicate lung transplantation. Inhaled nitric oxide (NO) and aerosolized prostacyclin (PGI2) both dilate the pulmonary vasculature and improve oxygenation in adult respiratory distress syndrome. We investigated whether similar effects would occur during early reperfusion of a lung graft.
Methods. Eighteen pigs underwent left lung transplantation. We measured blood flow distribution, mean pulmonary artery pressure, PVR, and gas exchange in each lung separately. Animals were randomized into three groups to receive NO (10 ppm/30 minutes, 40 ppm/30 minutes), nebulized PGI2 (25 µg/mL/30 minutes, 50 µg/mL/30 minutes), or no drugs (control).
Results. In the transplanted lung, PVR was significantly higher than in the native lung. Pulmonary vascular resistance of the transplanted lung was lower in the NO and PGI2 groups in comparison with the control group. During the first hour of inhalation, NO decreased PVR more than PGI2. Neither drug improved oxygenation in the graft.
Conclusions. Nitric oxide and PGI2 decreased PVR of the transplanted lung slightly, but the effect did not produce a normal pressure in pulmonary vasculature.
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