[Effect of glutathione pretreatment on lung ischemia-reperfusion injury during cardiopulmonary bypass].

Objective: To observe the clinical effect of glutathione (GSH) pretreatment on lung ischemia-reperfusion injury during cardiopulmonary bypass (CPB) and determine the mechanism.

Methods: Sixteen patients ready to replace heart valve(s) were randomly divided into the control and the treatment group. GSH diluted with normal saline solution was injected to the patients in the treatment group 36 h before the operation, while normal saline solution was injected to the patients in the control group. Malondiadehyde (MDA), Factor V III (FV III) and free hemoglobin (FHb) were detected in the left and right heart chamber at pre-CPB 5, 10, and 15 minutes after the heart resuscitation. The differences between the left and right were recorded. Arterial blood from the radius was analyzed for PO2/FiO2 at pre-CPB, 10 min, 1 h and 6 h after the heart resuscitation.

Results: (1) The impairment of PO2/FiO2 in the treatment group was less than that in the controls. (2) MDA, FV III and FHb concentration in the left chamber were higher than those in the right. Increases of the parameters in the treatment group were lower than those in the controls. (3) The simple correlations were determined between MDA-FV III, FHb-MDA and FHb-FV III in both the control and the treatment groups (r = 0.774, 0.753 and 0.802), with statistical significance.

Conclusion: GSH pretreatment can protect early lung ischemia-reperfusion injury during CPS, whose mechanism may be to decrease the leakage of FHb, and inhibit the free radicals reaction.