Pulsatile Pulmonary Perfusion During Cardiopulmonary Bypass Reduces the Pulmonary Inflammatory Response Matthias Siepe, MD, Ulrich Goebel, MD, Anne Mecklenburg,

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Pulsatile Pulmonary Perfusion During Cardiopulmonary Bypass Reduces the Pulmonary Inflammatory Response Matthias Siepe, MD, Ulrich Goebel, MD, Anne Mecklenburg, BS, Torsten Doenst, MD, Christoph Benk, BS, Philipp Stein, MD, Friedhelm Beyersdorf, MD, Torsten Loop, MD, Christian Schlensak, MD The Annals of Thoracic Surgery Volume 86, Issue 1, Pages 115-122 (July 2008) DOI: 10.1016/j.athoracsur.2008.03.062 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Protein expression of interleukin (IL)-1 and (B) IL-6 in the lung tissue is visualized by enzyme-linked immunoabsorbent assay. The left side shows the baseline values of the groups with CPB (black bar), CPB+CP (light gray bar), and CPB+PP (dark gray), and the respective values at the end of the investigation are highlighted on the ride hand side. Values are shown with the standard deviation. (CPB = cardiopulmonary bypass; CP = continuous perfusion; PP = pulsatile perfusion; $p < 0.001 CPB vs CPB+CP and CPB+PP; *p < 0.05 CPB+CP vs CPB+PP.) The Annals of Thoracic Surgery 2008 86, 115-122DOI: (10.1016/j.athoracsur.2008.03.062) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Caspase-3 activity in the lung tissue is visualized by fluorogenic assay. In the CPB+CP (red triangles) and CPB+PP (green triangles) groups, especially, caspase-3 activity values are lower than those in the CPB (open circles) group directly after bypass termination. At 60 minutes' postbypass time the caspase activity in the CPB+PP group is significantly lower compared with CPB (sham operation, solid circle). (CPB = cardiopulmonary bypass; CP = continuous perfusion; PP = pulsatile perfusion; #p < 0.05 groups CPB+CP and CPB+PP vs group CPB, *p < 0.05 CPB+PP vs CPB; data are presented with the standard deviation.) The Annals of Thoracic Surgery 2008 86, 115-122DOI: (10.1016/j.athoracsur.2008.03.062) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Electrophoretic mobility shift assays of intracellular transcription factor expression of (A) nuclear factor-κB and (B) activating protein in the two groups of cardiopulmonary bypass (CPB) plus continuous pulmonary perfusion (CPB+CP, light gray bars) and pulsatile pulmonary perfusion (CPB+PP, dark gray bars) compared with the conventional CPB group (black bars.) (*p < 0.05 vs CPB and CPB+PP group; data are presented with the standard deviation.) The Annals of Thoracic Surgery 2008 86, 115-122DOI: (10.1016/j.athoracsur.2008.03.062) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions