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Article ; Online: Costal margin injuries and trans-diaphragmatic intercostal hernia: Presentation, management and outcomes according to the Sheffield classification.

Byers, Jonathan L / Rao, Jagan N / Socci, Laura / Hopkinson, David N / Tenconi, Sara / Edwards, John G

The journal of trauma and acute care surgery

2023 Volume 95, Issue 6, Page(s) 839–845

Abstract: Background: Costal margin rupture (CMR) injuries are under-diagnosed and inconsistently managed, while carrying significant symptomatic burden. We hypothesized that the Sheffield Classification system of CMR injuries would relate to injury patterns and ... ...

Abstract	Background: Costal margin rupture (CMR) injuries are under-diagnosed and inconsistently managed, while carrying significant symptomatic burden. We hypothesized that the Sheffield Classification system of CMR injuries would relate to injury patterns and management options. Methods: Data were collected prospectively between 2006 and 2023 at a major trauma center in the United Kingdom. Computed tomography scans were interrogated and injuries were categorized according to the Sheffield Classification. Clinical, radiologic, management and outcome variables were assessed. Results: Fifty-four patients were included in the study. Intercostal hernia (IH) was present in 30 patients and associated with delayed presentation ( p = 0.004), expulsive mechanism of injury (i.e. such as occurs with coughing, sneezing, or retching), higher body mass index ( p < 0.001), and surgical management ( p = 0.02). There was a bimodal distribution of the level of the costal margin rupture, with IH Present and expulsive mechanism injuries occurring predominantly at the ninth costal cartilage, and IH Absent cases and other mechanisms at the seventh costal cartilage ( p < 0.001). There were correlations between the costal cartilage being thin at the site of the CMR and the presence of IH and expulsive etiology ( p < 0.001). Management was conservative in 23 and surgical in 31 cases. Extrathoracic mesh IH repairs were performed in 3, Double Layer Mesh Repairs in 8, Suture IH repairs in 5, CMR plating in 8, CMR sutures in 2, and associated Surgical Stabilization of Rib Fractures in 11 patients. There was one postoperative death. There were seven repeat surgical procedures in five patients. Conclusion: The Sheffield Classification is associated statistically with presentation, related chest wall injury patterns, and type of definitive management. Further collaborative data collection is required to determine the optimal management strategies. Level of evidence: Therapeutic/Care Management; Level III.
MeSH term(s)	Humans ; Rib Cage/surgery ; Hernia/etiology ; Hernia, Hiatal/complications ; Hernias, Diaphragmatic, Congenital/surgery ; Herniorrhaphy/methods ; Rupture/surgery
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000004068
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Zs.A 127: Show issues

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Article: Pulmonary adenocarcinoma is associated with poor long-term survival after surgical resection. Effect of allogeneic blood transfusion.

Ghosh, Sudip / Ahmed, Kamran / Hopkinson, David N / Vaughan, Roger

Cancer

2004 Volume 101, Issue 9, Page(s) 2058–2066

Abstract: Background: The significance of allogeneic blood transfusion in the prognosis of patients with nonsmall lung carcinoma (NSCLC) remains controversial. Reports have suggested that patients with adenocarcinoma have a worse prognosis from cancer than ... ...

Abstract	Background: The significance of allogeneic blood transfusion in the prognosis of patients with nonsmall lung carcinoma (NSCLC) remains controversial. Reports have suggested that patients with adenocarcinoma have a worse prognosis from cancer than patients with squamous cell carcinoma (SCC), but this evidence is lacking in NSCLC. The objective of the current study was to elucidate the correlation between perioperative allogeneic blood transfusion and the prognosis in patients with adenocarcinoma and SCC. Methods: The study group comprised 329 consecutive patients (172 men and 157 women) with a mean age of 67 years who underwent lung resection between 1996 and 2003 in 1 unit. The clinicopathologic and survival data were compared between 62 patients (42.7%) with adenocarcinoma and 58 patients (48.3%) with SCC who received a perioperative blood transfusion and 83 patients (57.3 %) with adenocarcinoma and 126 patients (61.3%) with SCC who did not. Results: The overall surgical mortality rate was 3.9% (13 deaths). The median surgical blood loss was 380 mL (range, 125-4500 mL). The mean blood transfusion received was 1.9 U (range, 0-8 U). The overall actuarial 1, 3, and 5-year survival rates in the adenocarcinoma and SCC groups were 82.3%, 49.6%, and 19.4% and 87.9%, 71.7%, and 32.7%, respectively (P = 0.021). Multivariate analysis demonstrated that the factors that appeared to be independent prognostic factors in both groups were T-classification (P < 0.001), lymph node metastasis (P < 0.001), and postoperative complications (P = 0.029). Perioperative blood transfusion was not an independent prognostic indicator in either group. Conclusions: The current study demonstrated that long-term survival in patients with adenocarcinoma of the lung was significantly worse compared with patients with SCC, but was independent of allogeneic perioperative blood transfusion. The results reaffirmed the importance of tumor invasion and lymph node involvement in the overall poor prognosis of these patients.
MeSH term(s)	Adenocarcinoma/mortality ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Blood Transfusion ; Female ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Prognosis ; Survivors
Language	English
Publishing date	2004-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.20590
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Uh III Zs.146: Show issues

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Article: Pulmonary graft preservation: a worldwide survey of current clinical practice.

Hopkinson, D N / Bhabra, M S / Hooper, T L

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

1998 Volume 17, Issue 5, Page(s) 525–531

Abstract: Background: Flush perfusion of pulmonary grafts with cold modified EuroCollins solution supplemented by prostaglandin treatment was introduced clinically 10 years ago. Primary graft failure remains a major cause of morbidity and death after lung ... ...

Abstract	Background: Flush perfusion of pulmonary grafts with cold modified EuroCollins solution supplemented by prostaglandin treatment was introduced clinically 10 years ago. Primary graft failure remains a major cause of morbidity and death after lung transplantation. During the last decade, much experimental work has led to reports of alternative storage solutions, differing storage conditions, and pharmacologic interventions that improve pulmonary graft performance. It is unclear how these findings have influenced current clinical practice. Methods: A worldwide survey of the 125 centers performing lung transplantation was conducted by questionnaire. Results: One hundred twelve replies were received (90%). Most centers (n = 86) continue to use EuroCollins solution (77%), of whom 69% include prostaglandin therapy and 32% donor steroid treatment. University of Wisconsin solution (UW) is used by 15 centers (13.5%), of which 10 (67%) use prostaglandin and seven (47%) use donor steroids. Nine centers use Papworth solution and one uses donor core cooling. The volume of flush used varied widely, from 20 to 120 ml/kg, with median volumes of 60, 60, and 30 ml/kg in centers using EuroCollins, UW, and Papworth solutions, respectively. Two thirds of centers using EuroCollins solution store grafts at 0 degrees to 5 degrees C, and one third at 5 degrees to 10 degrees C. One center that uses EuroCollins solution stores grafts at 10 degrees to 15 degrees C. Centers using UW solution are evenly split at 0 degrees to 5 degrees C and 5 degrees to 10 degrees C. Most centers that use Papworth solution store grafts at 5 degrees to 10 degrees C. Only six centers use superoxide radical scavengers. The maximum ischemic period accepted by centers varies from 4 to 12 hours, with median periods of 8, 7, 6, and 6 hours for the UW, EuroCollins, Papworth, and donor core cooling centers, respectively. All but one of the UW centers (93%) expressed satisfaction with the quality of graft preservation achieved by UW solution. Only 58 of the 86 centers using EuroCollins solution (67%) were satisfied. Six of nine centers using Papworth solution were satisfied. Conclusions: There has been a trend toward the use of UW solution and a slightly warmer storage temperature. However, for most centers, graft storage techniques have changed little over the last decade.
MeSH term(s)	Adenosine/administration & dosage ; Allopurinol/administration & dosage ; Glutathione/administration & dosage ; Graft Survival/physiology ; Humans ; Hypertonic Solutions/administration & dosage ; Insulin/administration & dosage ; Lung Transplantation/physiology ; Organ Preservation/methods ; Organ Preservation Solutions ; Perfusion ; Prostaglandins/administration & dosage ; Raffinose/administration & dosage ; Temperature
Chemical Substances	Euro-Collins' solution ; Hypertonic Solutions ; Insulin ; Organ Preservation Solutions ; Prostaglandins ; University of Wisconsin-lactobionate solution ; Allopurinol (63CZ7GJN5I) ; Glutathione (GAN16C9B8O) ; Adenosine (K72T3FS567) ; Raffinose (N5O3QU595M)
Language	English
Publishing date	1998-05
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	1062522-7
ISSN	1557-3117 ; 1053-2498
ISSN (online)	1557-3117
ISSN	1053-2498
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Article: 24-hour lung preservation: simplified versus conventional University of Wisconsin solution in a porcine model.

Wright, N C / Hopkinson, D N / Shaw, T E / Hooper, T L

Transplantation

2000 Volume 69, Issue 7, Page(s) 1261–1265

Abstract: Background: Experimentally, the University of Wisconsin solution (UW) has been shown to be superior to the EuroCollins solution (EC) for lung graft preservation. We showed previously that the inclusion of the trisaccharide raffinose as an impermeant in ... ...

Abstract	Background: Experimentally, the University of Wisconsin solution (UW) has been shown to be superior to the EuroCollins solution (EC) for lung graft preservation. We showed previously that the inclusion of the trisaccharide raffinose as an impermeant in the UW is largely responsible for this superiority. In this study, we used a new porcine model of isolated lung reperfusion to evaluate the use of a simple solution of phosphate-buffered raffinose (PBr) for lung preservation. Methods: Lungs were stored for 24 hr at 4 degrees C after a single pulmonary artery flush with either UW (n = 5) or PBr (n = 5) solution. Left lungs were ventilated with room air and reperfused for 4 hr by venovenous extracorporeal circulation from a support animal. Controls (n = 5) were flushed with UW and reperfused without storage. Results: Control lungs performed better than those stored in either solution in terms of oxygenation (P = 0.034) and airway pressure (P = 0.032). There were no significant differences between the two stored groups for any parameters. Data for stored lungs after 4 hr of reperfusion (means with 95% confidence intervals) include oxygenation (mm Hg): control 101.6 (14.5), UW 85.2 (14.5), PBr 75.0 (14.5); blood flow (ml/ min): control 572 (90), UW 466 (90), PBr 468 (90); peak airway pressure (mm Hg): control 15.9 (3.0), UW 21.0 (3.0), PBr 22.6 (3.0); pulmonary artery pressure (mm Hg): control 17.5 (3.2), UW 22.3 (2.9), PBr 24.5 (2.9). Graft edema (percentage tissue water): control 86.4 (0.8), UW 89.9 (1.8), PBr 89.3 (1.0). Conclusion: PBr is a far simpler and less expensive alternative to UW, and appears to provide a similar level of lung graft protection.
MeSH term(s)	Adenosine ; Allopurinol ; Animals ; Buffers ; Cryopreservation ; Evaluation Studies as Topic ; Extracorporeal Circulation ; Glutathione ; Insulin ; Lung/physiology ; Organ Preservation Solutions ; Phosphates ; Pulmonary Circulation ; Raffinose ; Reperfusion ; Swine ; Time Factors
Chemical Substances	Buffers ; Insulin ; Organ Preservation Solutions ; Phosphates ; University of Wisconsin-lactobionate solution ; Allopurinol (63CZ7GJN5I) ; Glutathione (GAN16C9B8O) ; Adenosine (K72T3FS567) ; Raffinose (N5O3QU595M)
Language	English
Publishing date	2000-04-15
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/00007890-200004150-00010
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: A porcine ex vivo paracorporeal model of lung transplantation.

Wright, N C / Hopkinson, D N / Shaw, T E / Hooper, T L

Laboratory animals

2000 Volume 34, Issue 1, Page(s) 56–62

Abstract: A technique is described which allows perfusion of an isolated, ventilated pig lung with an extracorporeal veno-venous circuit from a support animal. This model is stable for up to 4 h, and avoids some of the disadvantages of alternative small animal and ...

Abstract	A technique is described which allows perfusion of an isolated, ventilated pig lung with an extracorporeal veno-venous circuit from a support animal. This model is stable for up to 4 h, and avoids some of the disadvantages of alternative small animal and large animal models of lung transplantation. It may be useful in the investigation of factors affecting lung preservation and reperfusion injury.
MeSH term(s)	Animals ; Extracorporeal Circulation/veterinary ; Lung Transplantation/methods ; Lung Transplantation/veterinary ; Organ Preservation/methods ; Organ Preservation/veterinary ; Pulmonary Wedge Pressure ; Reperfusion Injury/prevention & control ; Swine
Language	English
Publishing date	2000-01
Publishing country	England
Document type	Journal Article
ZDB-ID	391008-8
ISSN	1758-1117 ; 0023-6772
ISSN (online)	1758-1117
ISSN	0023-6772
DOI	10.1258/002367700780577984
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Zs.B 1951: Show issues

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Article: Modulation of lung reperfusion injury by nitric oxide: impact of inspired oxygen fraction.

Bhabra, M S / Hopkinson, D N / Shaw, T E / Hooper, T L

Transplantation

1999 Volume 68, Issue 9, Page(s) 1238–1243

Abstract: Background: Attempts to attenuate lung reperfusion injury by administration of inhaled nitric oxide have yielded conflicting results. We hypothesized that the inspired oxygen fraction may play an important role in determining the outcome of nitric oxide ...

Abstract	Background: Attempts to attenuate lung reperfusion injury by administration of inhaled nitric oxide have yielded conflicting results. We hypothesized that the inspired oxygen fraction may play an important role in determining the outcome of nitric oxide therapy. Methods: Rat lungs were reperfused in a circuit incorporating a support animal either immediately after flushing (group A) or after 24-hr hypothermic storage (groups B-D). During the first 10 min of reperfusion, grafts were ventilated with 95% oxygen in groups A and B, 95% oxygen and 20 ppm nitric oxide in group C, and 20% oxygen and 20 ppm nitric oxide in group D. Ventilation during the subsequent 50 min of reperfusion was with 100% oxygen only, in all groups. Results: Graft function in group B was poor compared to group A in terms of blood flow and pulmonary artery and peak airway pressures. In group C, although 5 out of 10 grafts functioned at control levels, the remainder performed poorly. Function in group D, on the other hand, was uniformly good. Conclusions: Inhaled nitric oxide can prevent lung reperfusion injury, but this effect may be compromised by concurrent ventilation with high oxygen concentrations.
MeSH term(s)	Administration, Inhalation ; Animals ; Capillary Permeability ; Lung/blood supply ; Male ; Nitrates/metabolism ; Nitric Oxide/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury/prevention & control ; Vascular Resistance
Chemical Substances	Nitrates ; peroxynitric acid (26404-66-0) ; Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	1999-11-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/00007890-199911150-00005
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Giant pleural fibroma with an abdominal vascular supply mimicking a pulmonary sequestration.

Kaul, Pradeep / Kay, Samantha / Gaines, Peter / Suvarna, Simon Kim / Hopkinson, David N / Rocco, Gaetano

The Annals of thoracic surgery

2003 Volume 76, Issue 3, Page(s) 935–937

Abstract: A 37 -year-old woman was found to have a giant mass in her right chest with an abnormal abdominal vascular supply at preoperative workup. Suspecting a pulmonary sequestration, the lesion was embolized and then removed through a standard thoracotomy. A ... ...

Abstract	A 37 -year-old woman was found to have a giant mass in her right chest with an abnormal abdominal vascular supply at preoperative workup. Suspecting a pulmonary sequestration, the lesion was embolized and then removed through a standard thoracotomy. A broad-based, vascularized pedicle connected the mass to the diaphragm. Final pathology demonstrated a solitary fibrous tumor of the pleura with no malignant features. We believe this is the first case of solitary fibrous tumor of the pleura with a direct vascular supply from the abdominal aorta at the level of the renal arteries reported in the literature.
MeSH term(s)	Abdomen ; Adult ; Bronchopulmonary Sequestration/diagnosis ; Diagnosis, Differential ; Female ; Fibroma/blood supply ; Fibroma/diagnosis ; Humans ; Pleural Neoplasms/blood supply ; Pleural Neoplasms/diagnosis
Language	English
Publishing date	2003-04-21
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/s0003-4975(03)00553-8
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Zs.A 252: Show issues

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Article ; Online: Atrial myxomas: a single unit's experience in the modern era.

Owers, Corinne E / Vaughan, Paul / Braidley, Peter C / Wilkinson, Glen A L / Locke, Timothy J / Cooper, Graham J / Briffa, Norman P / Hopkinson, David N / Sarkar, Pradip K

The heart surgery forum

2011 Volume 14, Issue 2, Page(s) E105–9

Abstract: Background: Although an atrial myxoma is the commonest cardiac tumor, it is still relatively rare, with an annual incidence of approximately 0.5 per million. In our unit, which performs 1000 major cardiac procedures per year, this equates to ... ...

Abstract	Background: Although an atrial myxoma is the commonest cardiac tumor, it is still relatively rare, with an annual incidence of approximately 0.5 per million. In our unit, which performs 1000 major cardiac procedures per year, this equates to approximately 3 patients annually. We therefore sought to evaluate our experience of managing this type of tumor over the last 5 years. Methods: A retrospective review was performed of prospectively collected data from the departmental database. We analyzed consecutive patients who were operated upon between 2002 and 2007. Three patients with a papillary fibroelastoma on histological examination were excluded from this study. Results: We have performed excision of atrial myxoma in 18 patients. Twelve patients (66%) were female; the median age was 64 years (range, 35-80 years), and the median logistic euroSCORE was 5.22% (range, 1.51-27.82%). Fifteen patients (83%) were deemed urgent, 2 elective, and 1 emergency. Sixteen tumors (89%) were left sided. Symptoms attributable to the tumor were found in 16 of the 18 patients (embolic, n = 9; chest pain, n = 3; palpitations, n = 2; incidental finding, n = 2, others n = 4), and the mean time from diagnosis to operation was 3 days (range, 0-22 months). The median cardiopulmonary bypass time was 87 minutes (range, 28-228 minutes), with the median aortic cross clamp time being 61 minutes (16-175 minutes).The approaches used were transeptal via right atriotomy (n = 8), biatrial/Dubost (n = 4), left atrial (n = 4), and right atrial (n = 2); the interatrial septum was involved in 14 patients. The resultant defect was closed using a pericardial (n = 8) or prosthetic patch (n = 5) or directly sutured (n = 5). Concomitant procedures were performed in 8 patients (coronary artery bypass graft [CABG], n = 4; mitral valve replacement [MVR], n = 2; valve + grafts, n = 2). All tumors were completely excised.Postoperatively there were no deaths within 30 days of the procedure. Indeed, only 2 patients have died at 4 and 25 months postoperatively, respectively, both of unrelated causes. Median intensive therapy unit (ITU) stay was 2 days (range, 1-9 days), and median hospital stay was 10 days (range, 5-20 days). A permanent pacemaker was required in only 1 patient, and median blood loss was 340 mL (range, 140-1760 mL). Atrial fibrillation was the commonest complication affecting 6/18 patients (33%). Conclusions: Excision of atrial myxoma can be performed using a variety of intraoperative approaches and closure techniques, all with acceptable postoperative morbidity and low mortality rates. To date, no recurrences have been found at median 2-year follow-up.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cardiac Surgical Procedures/methods ; Cardiac Surgical Procedures/statistics & numerical data ; Cardiopulmonary Bypass ; Chest Pain ; Coronary Artery Bypass ; Female ; Health Status Indicators ; Heart Atria/pathology ; Heart Neoplasms/diagnosis ; Heart Neoplasms/pathology ; Heart Neoplasms/surgery ; Heart Valve Prosthesis Implantation ; Humans ; Intensive Care Units/statistics & numerical data ; Length of Stay ; Male ; Middle Aged ; Myxoma/diagnosis ; Myxoma/pathology ; Myxoma/surgery ; Retrospective Studies ; Treatment Outcome ; United Kingdom
Language	English
Publishing date	2011-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2069188-9
ISSN	1522-6662 ; 1098-3511
ISSN (online)	1522-6662
ISSN	1098-3511
DOI	10.1532/HSF98.20101163
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Zs.A 5745: Show issues

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Article: Low-dose nitric oxide inhalation during initial reperfusion enhances rat lung graft function.

Bhabra, M S / Hopkinson, D N / Shaw, T E / Hooper, T L

The Annals of thoracic surgery

1997 Volume 63, Issue 2, Page(s) 339–344

Abstract: Background: In ischemia-reperfusion injury, the production of nitric oxide by dysfunctional endothelium falls rapidly within minutes of the onset of reperfusion. Replenishment during this critical early period using inhaled nitric oxide may benefit lung ...

Abstract	Background: In ischemia-reperfusion injury, the production of nitric oxide by dysfunctional endothelium falls rapidly within minutes of the onset of reperfusion. Replenishment during this critical early period using inhaled nitric oxide may benefit lung grafts through modulation of vascular tone, endothelial permeability, neutrophil and platelet function, and availability of reactive oxygen species. Methods: Rat lung grafts were flushed with 60 mL/kg cold University of Wisconsin solution and were reperfused either immediately (group I, n = 5) or after 24-hour 4 degrees C storage (groups II and III, n = 5 each), for 60 minutes in an ex vivo model incorporating a support animal. Graft ventilation was with room air. In group III, 20 parts per million inhaled nitric oxide was added during the initial 10 minutes of reperfusion, whereas in groups I and II, equivalent flows of nitrogen were added to standardize oxygen concentration. Results: Compared with group I, graft function in group II was poor, with reductions in oxygenation and blood flow and elevations of mean pulmonary artery pressure, peak airway pressure, and wet to dry weight ratio. In contrast, during nitric oxide inhalation in group III, graft function improved to control levels. This improvement was subsequently sustained throughout the reperfusion period. Conclusions: Low-dose inhaled nitric oxide administration in the early phase of reperfusion of stored lung grafts can yield sustained improvement in function. There may be a role for inhaled nitric oxide in the prevention of reperfusion injury in transplanted lungs.
MeSH term(s)	Animals ; Blood Pressure ; Hemodynamics ; Lung Transplantation/physiology ; Male ; Nitric Oxide/therapeutic use ; Postoperative Complications/prevention & control ; Rats ; Rats, Sprague-Dawley ; Regional Blood Flow ; Reperfusion Injury/prevention & control
Chemical Substances	Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	1997-02
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/s0003-4975(96)01019-3
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Zs.A 252: Show issues

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Article: Attenuation of lung graft reperfusion injury by a nitric oxide donor.

Bhabra, M S / Hopkinson, D N / Shaw, T E / Hooper, T L

The Journal of thoracic and cardiovascular surgery

1997 Volume 113, Issue 2, Page(s) 327–33; discussion 333–4

Abstract: Objective: One of the primary features of ischemia-reperfusion injury is reduced production of protective autocoids, such as nitric oxide, by dysfunctional endothelium. Administration of a nitric oxide donor during reperfusion of lung grafts may ... ...

Abstract	Objective: One of the primary features of ischemia-reperfusion injury is reduced production of protective autocoids, such as nitric oxide, by dysfunctional endothelium. Administration of a nitric oxide donor during reperfusion of lung grafts may therefore be beneficial through modulation of vascular tone and leukocyte and platelet function. Methods: Rat lung grafts were flushed with University of Wisconsin solution and reperfused for 1 hour in an ex vivo model incorporating a support animal. Group I grafts (n = 6) were reperfused immediately after explantation, group II (n = 6) and III (n = 5) grafts after 24 hours of storage at 4 degrees C. In group III, glyceryl trinitrate, a nitric oxide donor, was administered during the first 10 minutes of reperfusion at a rate of 200 micrograms/min. In an additional group (n = 5), 200 micrograms/min hydralazine was administered instead, to assess the effect of vasodilation alone. Results: Graft function in group II deteriorated compared with that in group I, with significant reduction of graft effluent oxygen tension and blood flow and elevation of pulmonary artery pressure, peak airway pressure, and wet/dry weight ratio. In contrast, in group III, glyceryl trinitrate treatment improved graft function to baseline levels in all these parameters. Administration of hydralazine, meanwhile, produced mixed results with only two out of five grafts functioning at control levels. Conclusions: In this model, administration of glyceryl trinitrate to supplement the nitric oxide pathway in the early phase of reperfusion has a sustained beneficial effect on lung graft function after 24-hour hypothermic storage, probably through mechanisms beyond vasodilation alone.
MeSH term(s)	Animals ; Cardioplegic Solutions ; Disease Models, Animal ; Disease Progression ; Hemodynamics ; Hydralazine/therapeutic use ; Lung Transplantation/physiology ; Male ; Nitric Oxide/physiology ; Nitroglycerin/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury/physiopathology ; Reperfusion Injury/prevention & control ; Time Factors ; Vasodilator Agents/therapeutic use
Chemical Substances	Cardioplegic Solutions ; Vasodilator Agents ; Hydralazine (26NAK24LS8) ; Nitric Oxide (31C4KY9ESH) ; Nitroglycerin (G59M7S0WS3)
Language	English
Publishing date	1997-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/S0022-5223(97)70330-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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