Effects of Erythropoietin on Lung Injury Induced by Cardiopulmonary Bypass After Cardiac Surgery

Med Sci Monit. 2020 Apr 20:26:e920039. doi: 10.12659/MSM.920039.

Abstract

BACKGROUND Lung injury after cardiopulmonary bypass (CPB) is a serious postoperative complication and can affect the postoperative recovery. The purpose of this study was to explore whether erythropoietin (EPO) has an effect on lung injury caused by CPB. MATERIAL AND METHODS Sixty patients who received the CPB were randomly divided into a saline group and the EPO group. All the patients received saline or EPO preoperatively, respectively. The ventilation function, including dynamic compliance, peak airway pressure, and plateau pressure, were recorded. The level of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1ß, and IL-10 in serum and arterial blood gas were analyzed. The mechanical ventilation time in the intensive care unit (ICU), the length of time spent in the ICU, the time from operation to discharge, and the total time of hospitalization were recorded. Adverse events in the ICU were monitored and recorded. RESULTS EPO significantly decreased the level of TNF-alpha and IL-1ß, but increased the level of IL-10 after CPB. EPO significantly improved pulmonary ventilated function and gas exchange function after CPB. EPO significantly shortened the mechanical ventilation time and stay in the ICU. CONCLUSIONS Preoperative EPO injection reduced lung injury and promoted lung function in patients who underwent CPB. The protection effect of EPO may be associated with inhibition of inflammatory response.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiopulmonary Bypass / methods
  • China
  • Cytokines / blood
  • Erythropoietin / metabolism
  • Erythropoietin / therapeutic use*
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Interleukin-1beta
  • Lung / pathology
  • Lung Injury / drug therapy*
  • Lung Injury / etiology
  • Lung Injury / metabolism
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Period
  • Respiration, Artificial / adverse effects
  • Thoracic Surgical Procedures / adverse effects
  • Tumor Necrosis Factor-alpha

Substances

  • Cytokines
  • EPO protein, human
  • Inflammation Mediators
  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha
  • Erythropoietin