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The Journal of Cardiovascular Surgery 2000 April;41(2):207-13

language: English

Inflammatory response during simulated extracorporeal circulation with addition of nitric oxide

Borowiec J. W., Lahtinen M., Venge P. *, Henze A., Stiernström H. **

From the Departments of Cardiothoracic Surgery
*Clinical Chemistry
**Anestesiology
Uppsala University Hospital, Uppsala, Sweden


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Background. Heart oper­a­tions per­formed ­with extra­cor­po­real cir­cu­la­tion (ECC) are asso­ciat­ed ­with an inflamma­to­ry ­response. This ­response is par­tial­ly due to gra­nu­lo­cyte acti­va­tion. Leukocyte ­derived ­free rad­i­cals are ­involved in tis­sue inju­ry. The pur­pose of ­this ­study was to ­observe wheth­er nitric ­oxide influ­ence the inflam­ma­to­ry ­response dur­ing sim­u­lat­ed ECC.
Methods. In a mod­el of sim­u­lat­ed extra­cor­po­real cir­cu­la­tion, ­fresh ­whole ­human ­blood ­mixed ­with Ringer’s solu­tion was cir­cu­lat­ed ­through a ­heart-­lung ­machine for ­three ­hours. In ­five cir­cuits NO was add­ed to oxy­gen/air mix­ture (­group N), ­while ­five oth­er cir­cuits ­were ven­ti­lat­ed ­with oxy­gen/air mix­ture (­group C). The meth­ods for esti­mat­ing the inflam­ma­to­ry ­response ­were deter­mi­na­tion of oxy­gen ­free rad­i­cals pro­duc­tion capac­ity, ­using chem­ilu­mi­nes­cence, and meas­ure­ments of con­cen­tra­tion of gra­nu­lo­cyte ­derived pro­teins (mye­lop­e­rox­i­dase and ­human neu­troph­il lipoc­al­in).
Results. All meas­ured param­e­ters ­were sim­i­lar­ly inde­pen­dent of addi­tion­al sup­ply of ­nitric ­oxide ­almost through­out extra­cor­po­real cir­cu­la­tion ­time. The ­sole sig­nif­i­cant dif­fer­ence ­between the two ­groups was ­found at an ear­ly ­stage of extra­cor­po­real cir­cu­la­tion, ­when lumi­nol-­enhanced chem­ilu­mi­nes­cence in ­whole ­blood was high­er in the N ­group (1500, 1470-1950 vs 1038, 750-1050 in the con­trol ­group; ­medians ­with quar­tiles). A sim­i­lar ten­den­cy was ­observed in lucig­e­nin-­enhanced chem­ilu­mi­nes­cence at 60 min of extra­cor­po­real cir­cu­la­tion (625, 560-875 in the N ­group vs 400, 360-525 in the con­trol ­group; ­medians ­with quar­tiles).
Conclusions. Nitric ­oxide sup­ply ­does not influ­ence inflam­ma­to­ry ­response dur­ing ­three ­hours ­long extra­cor­po­real cir­cu­la­tion, ­although ­some pro­tec­tive ­effect on hydro­gen per­ox­ide pro­duc­tion in ­whole ­blood was detect­ed in the ­initial ­phase of extra­cor­po­real cir­cu­la­tion.

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