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.
β-adrenergic agonist infusion during extracorporeal lung perfusion : effects on glucose concentration in the perfusion fluid and on lung function / F. Valenza, L. Rosso, S. Coppola, S. Froio, J. Colombo, R. Dossi, J. Fumagalli, V. Salice, M. Pizzocri, G. Conte, S. Gatti, L. Santambrogio, L. Gattinoni. - In: THE JOURNAL OF HEART AND LUNG TRANSPLANTATION. - ISSN 1053-2498. - 31:5(2012 May), pp. 524-530.
|Titolo:||β-adrenergic agonist infusion during extracorporeal lung perfusion : effects on glucose concentration in the perfusion fluid and on lung function|
VALENZA, FRANCO (Primo)
ROSSO, LORENZO PAOLO ANTONIO (Secondo)
SANTAMBROGIO, LUIGI (Penultimo)
GATTINONI, LUCIANO (Ultimo)
|Parole Chiave:||Models, Animal ; Swine ; Animals ; Perfusion ; Adrenergic beta-Agonists ; Albuterol ; Glucose ; Respiratory Physiological Phenomena ; Extracorporeal Circulation ; Pulmonary Artery ; Lung ; Lung Transplantation ; Female ; Ex-vivo lung perfusion ; EVLP ; beta-agonist ; Lung metabolism ; Lung edema|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
Settore MED/21 - Chirurgia Toracica
|Data di pubblicazione:||mag-2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.healun.2012.02.001|
|Appare nelle tipologie:||01 - Articolo su periodico|