Protective effects of iloprost infusion through pulmonary artery on cardiopulmonary induced lung injury

PROTECTIVE EFFECTS OF ILOPROST INFUSION THROUGHPULMONARY ARTERY ON CARDIOPULMONARY BYPASSINDUCED LUNG INJURYDr.Mustafa Hakan ZORIloprost a prostacyclin analogue with a prolonged plasma half-life has beneficialeffects in chronic pulmonary hypertension, but their effects in acute lung injury is notwell known. We investigated whether iloprost infusion through pulmonary artery duringaortic clamp period prevents pulmonary dysfunction after cardiopulmonary bypass bymeasuring inflammatory cytokine levels (IL-1beta, IL-6, IL-8, TNF-alpha), white bloodcell counts from left atrium and lung biopsies.20 patients undergoing CABG operation were divided into two groups. The studygroup received iloprost (2 nanogr/kg/min) through pulmonary artery during aortic cross-clamp period, whereas the control group underwent a standart CABG operation. Bloodsamples were collected from left atrium through right superior pulmonary vein beforecommencing CPB, at the 5th, 20th minutes of aortic cross-clamp and after weaning frombypass. Blood for white blood cell counts and lung biopsy specimens were collected afterweaning from bypass.IL-1beta levels after weaning from CPB were significantly lower in the studygroup. IL-6 levels were also significantly lower in the study group. IL-8 levels werefound to be significantly lower both at the 20th minute of aortic clamp and after CPB.TNF-alpha levels were also significantly lower in the study group after CPB. WBCcounts were found to be significantly lower in the study group. Lung biopsy specimensshowed marked inflammatory response in control group.Iloprost infusion via a cathater introduced through pulmonary artery, duringaortic cross-clamp period decreases the inflammatory response and acute lung injury afterCPB.