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The Annals of Thoracic Surgery, Vol 40, 139-143, Copyright © 1985 by The Society of Thoracic Surgeons
D Royston, BD Minty, TW Higenbottam, J Wallwork and GJ Jones
We measured the rate of clearance of technetium 99m-labeled
diethylenetriamine pentaacetate (99mTcDTPA) (molecular weight, 492 daltons)
from the lung into the blood (T1/2LB) in 9 patients before and after
operation with cardiopulmonary bypass (CPB). Two hours postoperatively,
T1/2LB fell from 49.3 +/- 13.6 minutes (mean +/- standard deviation) to
24.0 +/- 12.8 minutes (p less than 0.001). In addition, alveolar-arterial
oxygen tension difference P(A-a)O2 had increased from 73 +/- 28 mm Hg to
164 +/- 37 mm Hg (p less than 0.001). The rates of clearance of 99mTcDTPA
had returned to preoperative times by 7 days after operation, although
there was still a significant (p less than 0.05) elevation in P(A-a)O2.
Postoperative respiratory failure developed in 1 patient. The only
abnormality of lung function detected preoperatively was an increased
clearance rate for 99mTcDTPA (T1/2LB, 18 minutes). This study has shown an
increased clearance from the lung of a low-molecular-weight molecule
following operation with CPB. This finding should allow a more rational
approach to elucidating the mechanisms of injury to the gas-blood interface
in the lung following this type of operation.
ARTICLES
The effect of surgery with cardiopulmonary bypass on alveolar-capillary barrier function in human beings
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