β-adrenergic agonist infusion during extracorporeal lung perfusion : effects on glucose concentration in the perfusion fluid and on lung function

BACKGROUND: We recently showed in a pig model of ex vivo lung perfusion (EVLP) that lung edema correlates with glucose consumption. We investigated whether salbutamol, a beta-adrenergic receptor agonist known to upregulate fluid transport in the lung, modulates glucose concentration in the perfusate during EVLP. METHODS: Lungs from domestic pigs underwent normothermic EVLP. At the end of controlled reperfusion, lungs were ventilated and perfused for 60 minutes, then randomized to salbutamol (beta-Agonist) infusion or placebo (Control) for 180 minutes. Functional parameters were assessed. RESULTS: In the beta-Agonist group, glucose concentration decreased over time more than corresponding Control values (analysis of variance [ANOVA], p = 0.05). Mean pulmonary artery pressure (mPAP) was 16 +/- 1 mm Hg in the beta-Agonist group vs 21 +/- 1 mm Hg in the Controls (ANOVA p < 0.05). Baseline mPAP was correlated with the drop of mPAP after the p-agonist infusion (R-2 = 0.856, p < 0.05). Dynamic compliance dropped from 51 10 to 31 6 ml/cm 1420 in the P-Aeonist group and from 60 +/- 4 to 21 +/- 3 ml/cm H2O in the Control group (ANOVA, p < 0.05 beta-agonist vs Control). The A partial pressure of oxygen/fraction of inspired oxygen was 418 +/- 15 and 393 +/- 12 mm Hg in the P-Agonist and Control groups, respectively (t-test p = 0.106). CONCLUSIONS: Glucose concentration in the perfusate was affected by salbutamol. Salbutamol was associated with lower pulmonary pressures and better lung mechanics. These data suggest a possible role for salbutamol as a pharmacologic adjunct during EVLP before transplantation.