Differential effects of inhaled and intravenous sildenafil in the prevention of the pulmonary endothelial dysfunction due to cardiopulmonary bypass

被引:22
作者
Aubin, Marie-Claude [2 ]
Laurendeau, Steve [1 ,2 ]
Mommerot, Arnaud [1 ,2 ,3 ]
Lamarche, Yoan [1 ,2 ]
Denault, Andre [2 ,4 ]
Carrier, Michel [1 ,2 ]
Perrault, Louis P. [1 ,2 ]
机构
[1] Montreal Heart Inst, Dept Surg, Montreal, PQ H1T 1C8, Canada
[2] Univ Montreal, Dept Pharmacol, Montreal, PQ H3C 3J7, Canada
[3] Univ Hosp, Dept Cardiovasc Surg, Strasbourg, France
[4] Montreal Heart Inst, Dept Anesthesiol, Montreal, PQ H1T 1C8, Canada
关键词
endothelium; pulmonary arterial pressure; cardiopulmonary bypass; inflammatory response;
D O I
10.1097/FJC.0b013e3181598279
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The objective of the present study was to evaluate the effects of inhaled and intravenous sildenafil on the pulmonary endothelium-dependent relaxations, the hemodynamic profile and oxygenation after cardiopulmonary bypass. Five groups of Landrace swine were compared: 1) control; 2) cardiopulmonary bypass: 90 min of normothermic cardiopulmonary bypass; 3) precardiopulmonary bypass sildenafil nebulization; 4) postcardiopulmonary bypass sildenafil nebulization; 5) intravenous sildenafil administration prior to cardiopulmonary bypass. All groups underwent a 60-min period of pulmonary reperfusion after cardiopulmonary bypass. Vascular reactivity of second-degree pulmonary arteries was evaluated in response to acetylcholine and bradykinin. Cardiopulmonary bypass caused a significant decrease in endothelium-dependent relaxations to both agonists; this dysfunction was prevented by administration of sildenafil, both intravenous and inhaled (P < 0.05). Both administration routes prevented the significant increase in mean pulmonary arterial pressure with a safe hemodynamic profile. Moreover, intravenous and inhaled sildenafil after cardiopulmonary bypass also prevented the increase in alveoloarterial gradient (P < 0.05). Both sildenafil formulations of administration prevent the occurrence of pulmonary endothelial dysfunction. Depending on the administration moment and the route, the administration of sildenafil improves the hemodynamic profile and post-cardiopulmonary bypass oxygenation.
引用
收藏
页码:11 / 17
页数:7
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