Hyperoxic ventilation exacerbates lung reperfusion injury

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Presentation transcript:

Hyperoxic ventilation exacerbates lung reperfusion injury Peter I. Ellman, MD, Jeffrey S. Alvis, MD, Carlos Tache-Leon, MD, Ramesh Singh, MD, T. Brett Reece, MD, John A. Kern, MD, Curtis G. Tribble, MD, Irving L. Kron, MD The Journal of Thoracic and Cardiovascular Surgery Volume 130, Issue 5, Pages 1440.e1-1440.e8 (November 2005) DOI: 10.1016/j.jtcvs.2005.06.037 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Time course of Po2/fraction of inspired oxygen (Fio2) in the control and ischemia-reperfusion groups (control group, n = 6; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. There were no significant differences between groups at any time point when the comparing Po2/Fio2 ratio. However, a trend toward a higher Po2/Fio2 ratio in the room air group when compared with the hyperoxic group can be seen at 90 minutes (P = .08). The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Time course of ventilation measured on the basis of Pco2 in the pulmonary venous blood gas in control and ischemia-reperfusion groups (control group, n = 6; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. Ventilation was significantly better in the room air group compared with in the hyperoxic group at 120 minutes (P = .04). The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Lung edema measured on the basis of lung wet/dry ratios after 2 hours of reperfusion in the control and ischemia-reperfusion groups (control group, n = 6; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. Lung edema was significantly higher in the hyperoxic group compared with in the room air group. *P = .002, analysis of variance; P = .04, hyperoxia vs room air. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Myeloperoxidase activity in the control and ischemia-reperfusion groups (control group, n = 5; room air [RA] group, n = 8; 100% Fio2 group [100%], n = 9). Values are presented as means ± standard error of the mean. Myeloperoxidase activity was not significantly different between groups (P = .11, RA vs 100%). The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 A diagram of the blood perfused isolated lung apparatus. RES, reservoir; DEOX, deoxygenator; ABG, arterial blood gas. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Time course of mean pulmonary artery pressures in the control and ischemia-reperfusion groups (control group, n = 5; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. Mean pulmonary artery pressures were not significantly different between the hyperoxic and room air groups. The hyperoxic and room air groups were significantly different compared with the control group at 0 and 60 minutes *P ≤ .001, analysis of variance at 0 minutes; P = .025, analysis of variance at 60 minutes. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Time course of peak inspiratory pressures in the control and ischemia-reperfusion groups (control group, n = 5; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. Peak inspiratory pressures were not significantly different between the hyperoxic and room air groups. The hyperoxic and room air groups had significantly higher peak inspiratory pressures compared with the control group at 0, 30, and 60 minutes. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Oxygenation by arterial blood gas at 120 minutes (control group, n = 6; room air [RA] group, n = 10; 100% Fio2 group [100%], n = 10). Values are presented as means ± standard error of the mean. Oxygenation was not different between groups when comparing Po2 on a fraction of inspired oxygen (Fio2) of 100% for all groups. The room air group received an Fio2 of 100% for the last 15 minutes of the experiment. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 1440.e1-1440.e8DOI: (10.1016/j.jtcvs.2005.06.037) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions