体外循环期间肺动脉灌注含前列腺素e1氧合血对肺保护作用的研究-内科学(心血管)专业论文.docx

新疆医科大学医学博士学位论文perfusion during cardiopulmonary bypass warrant further investigation. Further elucidation of the underlying mechanism will help to refine therapeutic strategies for patients who need cardiac surgery. Objective: To study effect of continuous pulmorary artery perfusion with oxygenated blood on lung injury during cardiopulmonary bypass. and to evaluate the protective effect of prostaglandin E1 on lung from acute injury induced by cardiopulmonary bypass in order to conclude the mechanism of protective effect of prostaglandin E1 on lung. Method: Forty-five paitents undergoing valve replacement were divided randomly into three groups: control group (n=15); perfusion group (n=15): patients received pulmonary artery perfusion with oxygenated blood; Prostaglandin E1 group: patients received pulmonary perfusion with oxygenated blood and Prostaglandin E1. The patients in control group were performed the routine procedure of CPB and maintained mechanical ventilation during CPB. The patients in perfusion group were perfused with oxygenated blood continuously in the pulmonary artery and maintained mechanical ventilation during CPB. The patients in prostaglandin E1 group were perfused with oxygenated blood and prostaglandin E1 continuously and maintained mechanical ventilation during CPB. Administeration of anesthetic machine before and after blocking the caval vein: tidal volume (VT) 10ml/kg, freguency 12bpm, FiO2 100%, PEEP 5cm H2O Administeration of anaesthetic machine during blocking the caval vein: VT 5ml/kg. freguency 12bpm, FiO2 100%, PEEP 50mH2O. Administeration of anaesthetic machine after back to ICU: VT 10ml/kg, frequency 12bpm, FiO2 50%, PEEP 5cmH2O. Respiratory Index (RI) was calculated before CPB, 30mins after being taken back to ICU and before extubation. Blood samples were drawn from the radial artery at the following time points: after anaesthesia; 1 hours after the removal of aortic cross-damp; 3 hours after the removal of aortic across-clamp; 6hou