Vasoconstrictive eicosanoid responses to extracorporeal circulation with or without an oxygenator in fetal lambs

Introduction. This study measured levels of vasoconstrictive eicosanoids du ring ovine fetal cardiac bypass and compared the measurements between two g roups: (1) a group in which the placenta functioned as the only source of o xygen supply during the bypass (the placenta group), and (2) a group in whi ch an artificial oxygenator instead of the placenta, was included in the by pass circuit (the oxygenator group). Materials and Methods. A total of 16 fetal lambs were randomly assigned int o either the oxygenator group or the placenta group. Following anesthesia, the fetal cardiac bypass procedure was performed. The placenta group used a centrifugal pump as the pumping device without an oxygenator during the by pass. The bypass circuit in the oxygenator group consisted of a roller pump and a membrane oxygenator The fetal cardiac bypass procedure was performed for 30 minutes at normothermia in both groups. For the measurements of thr omboxane B-2(TXB2) and prostaglandin E-2(PGE(2)), blood sampels were taken before the bypass, at 5 minutes, 15 minutes, and 30 minutes after the start of cardiac bypass, and at 15 minutes after weaning from the bypass. TXB2 a nd PGE(2) levels were determined by radioimmunoassay with PGE(2)(I-125) and TXB2(I-125) assay systems. Hemodynamic observations and arterial blood gas analyses were done every 10 minutes. Results. The mean arterial pressure and heart rate ranged from 69.8 to 82.6 mmHg and 169 to 182/min during the bypass in the oxygenator group, and fro m 14.4 to 44.7 mmHg and 64.3 to 75/min in the placenta group. Arterial bloo d gas analysis showed severe hypercapnia and hypoxemia with acidosis during and after the bypass in the placenta group. Bypass flow rates were maintai ned at 140.3-164.0 ml/kg/min in the oxygenator group, while flow rates were suboptimal (74.3-97.0 ml/kg/min) in the placenta group. There were no stat istically significant differences in PGE(2) concentrations before, during, or after bypass, although the placenta group displayed a tendency to higher measurements during bypass, compared to the oxygenator group. The placenta group also showed higher TXB2 measurements than the oxygenator group durin g the bypass (p=0.0457). Conclusions. We have demonstrated increase measurements of PGE(2) and TXB2 in the placenta group when compared with the oxygenator group in an ovine f etal cardiac bypass model, although the PGE, difference failed to reach sta tistical significance.