CLINICAL STUDY OF POSTPERFUSION LUNG SYNDROME

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Although beneficial effects of membranous oxygenator for open heart surgery on the respiratory function have been reported, controversy still exists.The influence of various perioperative factors on the postoperative respiratory index (RI, RI=AaDO2/PaO2) was examined in 28 cardiac surgical patients. The factors considered were as follows; (1) perfusion time, perfusion pressure, lowest body temperature, highest PaO2, minimal hematocrit (Hct), blood and water balance, blood trauma (platlet count and free Hb), serum complement levels (C3, C4, CH50, C3a, C4a) during extracorporial circulation (ECC), (2) blood loss and blood transfusion, urine output and fluid infusion during operation, and (3) postoperative hemodynamics. No single factor contributes to RI changes significantly using single regression analysis. These patients were diveded into 2 groups according to RI; Group A (14 pts), RI<1.9, Group B (14 pts), RI≥1.9. These two groups were significantly differentiated by the linear discriminant function (p<0.01) in respects to the function of perfusion time×maximal PaO2 during ECC, loss of C3 and C4, and preoperative RI. Possibility of maldiscrimination was estimated about 7%.From these results it is concluded that changes in the RI is influenced by oxygen stress and activation of serum complements during ECC which probably contributes to the development of reperfusion injury of the lung.
一般社団法人日本人工臓器学会の論文