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Clinical Analysis of Contrasting between Ambroxol and Aprotinin on Lung Protection during Cardiopulmonary Bypass

Author: WangRongSheng
Tutor: ChenJian
School: Nanchang University
Course: Surgery
Keywords: CPB Lung protection Ambroxol Aprotinin
CLC: R654.2
Type: Master's thesis
Year: 2008
Downloads: 62
Quote: 0
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Abstract

Although CPB (Cardiopulmonary bypass, CPB) technology development so far has an extremely significant progress, but lung injury after CPB is still one of the major complications. CPB incidence of postoperative pulmonary dysfunction as high as 15% to 30%, severe cases can lead to acute respiratory distress syndrome and death [1]. Currently on CPB lung injury mechanism is not very clear, most scholars believe that the findings of the blood of its mechanism of injury is mainly caused by exposure to artificial surfaces systemic inflammation, lung ischemia-reperfusion lung injury and CPB time in a relatively \high metabolism, high oxygen consumption state [2]. Clinically, we use a variety of drugs or methods to reduce lung injury. Which serum protease inhibitor aprotinin alone was shown to have a certain degree of lung protection. But because it could cause amyloidosis on renal function and many terminally target organ damage [3] its clinical application is subjected to certain restrictions. Although protease inhibitors are more documented pulmonary Ulinastatin protective effect, but because of its emerging drugs, more expensive, and may have some side effects not yet discovered, is not yet large-scale application in clinical practice. If we can prove that we also have a good cardiopulmonary bypass lung protection, the cost can be achieved with less lung protection. The phlegm drugs commonly used in clinical trials to take ambroxol (ambroxol ambroxol), to study the lung during cardiopulmonary bypass protection and lung protection with aprotinin compared. If we can prove that we also have a good cardiopulmonary bypass lung protection, and assume aprotinin able to catch up with even more than the words, you can achieve better cost with less lung protective role for providing some theoretical and clinical experimental basis. Purpose 1. Verify mucosolvan during cardiopulmonary bypass lung protection. 2 Research mucosolvan with aprotinin during cardiopulmonary bypass in lung protective effect of different. 3 explore the use of cardiopulmonary bypass to reduce lung injury mucosolvan clinical feasibility. Methods Jiangxi Provincial People's Hospital Cardiothoracic Surgery May 2007 to January 2008 between cardiopulmonary bypass blocking time over 40 minutes, 36 serum samples from patients were randomly divided into the aprotinin group (A1), the target group of ambroxol (A2) and blank control group (A3). Each group of 12 people. Aprotinin group, only adding aprotinin in the priming, priming ambroxol group added ambroxol in the control group, only added to normal saline. Three groups of patients no significant difference in clinical data. Treatment for cardiac malformations. After extracting three groups of patients before surgery, aortic opening hours (0h), after the opening of 6h, 12h and 24h, 2ml blood. Were measured interleukin-8 (IL-8) and malondialdehyde (MDA) values. And extract arterial blood gas analysis to calculate the time of the respiratory index, peak airway pressure and oxygenation index for statistical analysis to compare the difference between the three groups and relationships. Results variety of inflammatory cytokines were significantly higher in the patients, MDA, IL-8 after 0h, 6h, 12h and 24h A1, A2 group were lower than A3, P <0.05, other than 12h and 24h A1 A2, P <0.05. QI and RI in the postoperative 0h, 6h, 12h and 24h A1 and A2 are better than A3, P <0.05; A1 and A2 were no significant differences; A1 and A2, 6, 12 hours after surgery, airway pressure were Less than A3, P <0.05; A1 and A2 was no significant difference. Conclusions 1. Experiments confirmed mucosolvan during cardiopulmonary bypass with lung protective effect. 2 mucosolvan lung during cardiopulmonary bypass in the early and the protective effect of aprotinin was no significant difference, but in the late surgery with aprotinin compared to the weaker. 3 mucosolvan for lung protection during cardiopulmonary bypass certain clinical feasibility and significance.

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