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J Appl Physiol 82: 1776-1784, 1997;
8750-7587/97 $5.00
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Journal of Applied Physiology
Vol. 82, No. 6, pp. 1776-1784, June 1997
PULMONARY CIRCULATION AND LUNG FLUID BALANCE

Selective endothelial dysfunction in conscious dogs after cardiopulmonary bypass

Paul Zanaboni, Paul A. Murray, Brett A. Simon, Kenton Zehr, Kirk Fleischer, Elaine Tseng, and Daniel P. Nyhan

Department of Anesthesiology and Critical Care Medicine and Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-8711 

Received 4 November 1996; accepted in final form 3 January 1997.

Zanaboni, Paul, Paul A. Murray, Brett A. Simon, Kenton Zehr, Kirk Fleischer, Elaine Tseng, and Daniel P. Nyhan. Selective endothelial dysfunction in conscious dogs after cardiopulmonary bypass. J. Appl. Physiol. 82(6): 1776-1784, 1997.---It has previously been demonstrated that cardiopulmonary bypass (CPB) causes prolonged pulmonary vascular hyperreactivity (D. P. Nyhan, J. M. Redmond, A. M. Gillinov, K. Nishiwaki, and P. A. Murray. J. Appl. Physiol. 77: 1584-1590, 1994). This study investigated the effects of CPB on endothelium-dependent (acetylcholine and bradykinin) and endothelium-independent (sodium nitroprusside) pulmonary vasodilation in conscious dogs. Continuous left pulmonary vascular pressure-flow (LP-Q) plots were generated in conscious dogs before CPB and again in the same animals 3-4 days post-CPB. The dose of U-46619 used to acutely preconstrict the pulmonary circulation to similar levels pre- and post-CPB was decreased (0.13 ± 0.01 vs. 0.10 ± 0.01 mg · kg-1 · min-1, P < 0.01) after CPB. Acetylcholine, bradykinin, and sodium nitroprusside all caused dose-dependent pulmonary vasodilation pre-CPB. The pulmonary vasodilator response to acetylcholine was completely abolished post-CPB. For example, at left pulmonary blood flow of 80 ml · kg-1 · min-1 acetylcholine (10 µg · kg-1 · min-1) resulted in 72 ± 15% reversal (P < 0.01) of U-46619 preconstriction pre-CPB but caused no change post-CPB. However, the responses to bradykinin and sodium nitroprusside were unchanged post-CPB. The impaired pulmonary vasodilator response to acetylcholine, but not to bradykinin, suggests a selective endothelial defect post-CPB. The normal response to sodium nitroprusside indicates that cGMP-mediated vasodilation is unchanged post-CPB.

pulmonary circulation; endothelium-dependent vasodilation; endothelium-independent vasodilation; chronic instrumentation; pressure-flow plots


0161-7567/97 $5.00 Copyright © 1997 the American Physiological Society




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