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Low-frequency ventilation during cardiopulmonary bypass for lung protection: A randomized controlled trial

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)385-399
Number of pages15
JournalJournal of Cardiac Surgery
Volume34
Issue number6
Early online date2 May 2019
DOIs
DateAccepted/In press - 4 Mar 2019
DateE-pub ahead of print - 2 May 2019
DatePublished (current) - 1 Jun 2019

Abstract

Objective: Pulmonary dysfunction is a common complication in patients undergoing heart surgery. Current clinical practice does not include any specific strategy for lung protection. To compare the anti-inflammatory effects of low-frequency ventilation (LFV), as measured by nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) p65 pathway activation, for the entire cardiopulmonary bypass (CPB) vs both lungs left collapsed in patients undergoing coronary artery bypass grafting (CABG). Methods: Two groups parallel randomized controlled trial. The primary outcome was inflammation measured by NF-κB p65 activation in pre- and post-CPB lung biopsies. Secondary outcomes were additional inflammatory markers in both biopsy tissue and blood. Results: Thirty-seven patients were randomly allocated to LFV (18) and to both lungs left collapsed (19). The mean concentration of NF-κB p65 in the biopsies before chest closure (adjusted for pre-CPB concentration) was higher in the LFV group compared to both lungs left collapsed group but this was not significant (0.102, 95% confidence interval, −0.022 to 0.226, P = 0.104). There were no significant differences between groups in the other inflammatory markers measured in tissue and blood. Conclusions: In patients undergoing elective CABG, the use of LFV during CPB when compared to both lungs left collapsed does not seem to reduce inflammation in lung biopsies and blood.

    Research areas

  • cardiopulmonary bypass, low-frequency ventilation, lung biopsy, lung protection, nuclear factor κ-light-chain-enhancer of activated B cells

    Structured keywords

  • Centre for Surgical Research

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Wiley at https://onlinelibrary.wiley.com/doi/full/10.1111/jocs.14044 . Please refer to any applicable terms of use of the publisher.

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    Embargo ends: 2/05/20

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