Background and Goal of Study : Reperfusion injury remains an important clinical problem after lung transplantation. ß-adrenergic stimulation of alveolar liquid clearance has been described to resolve pulmonary edema. In this study we investigated the effect of terbutaline in an isolated model of hydrostatic pulmonary edema
Materials and Methods : Pig lungs were flushed with cold Perfadex®, explanted and divided in 3 groups (n=5/group). After a cold ischemic time of 70 min., they were reperfused and ventilated in an isolated circuit. Pulmonary artery perfusion pressure was fixed to 15 mmHg in group I [Control] and increased to 25 mmHg in groups II [Placebo] and III [Terbutaline]. At 40 min. of reperfusion, 50 ml of saline was instilled in all groups, with the addition of 10-5 M Terbutaline in group III only.
Haemodynamic, aerodynamic and oxygenation parameters were recorded up to two hours. Wet-to-Dry weight ratio (W/D) was calculated after reperfusion.
Results : Data (Mean±SEM) are listed in Table:
|
Control |
Placebo |
Terbutaline | |
| Time |
90' |
90' |
90' |
| PVR1 |
497* + 38 |
798 + 50 |
563* + 56 |
| MeanAwP2 |
2 8.2* + 0.2 |
9.1 + 0.3 |
7.8* + 0.3 |
| PlatAwP2 |
16.4* + 0.8 |
2 20.4 + 1.0 |
16.2* + 1.0 |
| pO2/FiO22 |
555 + 28 |
534 + 14 |
528 + 54 |
| W/D |
4.7* + 0.1 |
5.7 + 0.2 |
4.5* + 0.2 |
*p<0.05 Control and Terbutaline versus Placebo;
1Dynes x sec x cm-5 ; 2mmHg.
There were no significant differences for all parameters between Control and Terbutaline.
Conclusions :
1)Elevation of pulmonary artery perfusion pressure induced reperfusion edema in Placebo versus Control.
2)Endotracheal administration of Terbutaline resulted in a decrease of pulmonary edema.
Instillation of a ß-adrenergic drug, therefore, might be a new promising tool to resuscitate patients suffering from severe ischemia-reperfusion injury after lung transplantation.