INCREASED LUNG INJURY IN PULMONARY HYPERTENSIVE PATIENTS DURING OPEN-HEART OPERATIONS

To investigate lung injury in adult open heart operations during extra corporeal circulation, we measured plasma chemiluminescence levels. Ni neteen patients were divided into two groups depending on preoperative pulmonary artery pressure: a pulmonary hypertension group (n = 11) an d a control group (n = 8). Plasma samples were taken simultaneously fr om arterial and central venous lines at six different points during an d early after operation. Arteriovenous difference of chemiluminescence (counts/10 seconds) increased significantly only in the pulmonary hyp ertension group (from -19.1 +/- 8.3 at the end of cross-clamping to 23 .7 +/- 12.4 at the end of bypass; p < 0.01). There was a positive corr elation between peak values of arterial plasma chemiluminescence and p ostoperative respiratory index in the pulmonary hypertension group (p < 0.05). In addition, during the first 12 hours postoperatively, arter iovenous difference of chemiluminescence in the pulmonary hypertension group changed significantly from negative to positive values (p < 0.0 5). These data suggest that free radical activity (detected by chemilu minescence) was deeply involved in lung injury during and also early a fter open heart operations, especially in pulmonary hypertensive patie nts.