Key result
Levosimendan administered via pulmonary perfusion reduced malonaldehyde concentrations and increased superoxide dismutase concentrations compared to intravenous administration or control.
Why the study?
Does levosimendan reduce lung injury in a canine model of cardiopulmonary bypass?
RCT (n=32)
Randomized
Does levosimendan reduce lung injury in a canine model of cardiopulmonary bypass?
In a canine model of cardiopulmonary bypass, levosimendan administered via pulmonary perfusion provided significant lung protection by reducing oxidative stress and tissue impairment.
Answers are grounded in this paper and cite their sources.
Pulmonary levosimendan perfusion may attenuate CPB lung injury in canines; leaves open translation to human practice pending trials.
BACKGROUND AND OBJECTIVES: To explore the lung-protective effect of levosimendan (LS) during cardiopulmonary bypass in a canine model by determining the wet/dry weight (W/D) ratio of lung tissue, malonaldehyde (MDA) and superoxide dismutase (SOD) concentrations, and performing a histological evaluation. MATERIALS AND METHODS: Thirty-two canines were divided randomly into four groups and underwent a routine aortic cross-clamping cardiopulmonary bypass procedure for 1 h, followed by recovery for 2 h. Animals were handled as follows: group C (means control group), no special treatment after aortic cross clamping; group P (means pulmonary artery perfusion group), pulmonary artery perfusion with cold oxygenated blood after aortic cross clamping; group LSIV (means intravenous injection of LS group), intravenous injection of LS (65 µg/kg) before thoracotomy, and the rest of the procedure was identical to the control group; group LPS (means pulmonary perfusion with LS group), pulmonary perfusion with cold oxygenated blood combined with LS (65 µg/kg) after aortic cross clamping. Lung tissues were removed and subjected to evaluation of pathological alterations, W/D ratio and MDA and SOD concentrations. RESULTS: In group C, the W/D ratio and MDA concentration were higher, while the SOD concentrations were lower (p<0.05). Compared with groups P and LSIV, the MDA concentration was lower in group LPS, while that of SOD was higher (p<0.05); Light and electron microscopy indicated that LS intervention reduced impairment of lung tissues. CONCLUSION: Our findings suggest that LS plays an important role in protecting lung tissues.
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Feng et al. (2016) conducted an RCT in Lung injury during cardiopulmonary bypass (n=32). Levosimendan vs. Control (no special treatment) or pulmonary artery perfusion with cold oxygenated blood was evaluated on Wet/dry weight (W/D) ratio of lung tissue, malonaldehyde (MDA) and superoxide dismutase (SOD) concentrations (p=<0.05). Levosimendan administered via pulmonary perfusion reduced malonaldehyde concentrations and increased superoxide dismutase concentrations compared to intravenous administration or control.
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