Effects of High-Dose Mucosolvin on Lung Functions in Infant Patients with Cardiopulmonary Bypass

Authors

  • Kun Zhao
  • Wen Wang
  • Jinzhou Zhang
  • Rong Zhao
  • Tao Chen
  • Jie Su
  • Chao Ma
  • Qin Cui

DOI:

https://doi.org/10.1532/HSF98.20101165

Abstract

Background: Cardiopulmonary bypass may cause serious impairment of lung function. It has been reported that administration of mucosolvin can prevent acute respiratory insufficiency through the improvement of pulmonary surfactant.

Objectives: This study aimed to explore the effects of high-dose mucosolvin on infant lungs following cardiopulmonary bypass.

Methods: One hundred infants were randomly divided into 2 groups. In Group 1, patients did not receive any respiratory drug perioperatively and underwent conventional mechanical ventilation postoperatively. In Group 2, patients were administered mucosolvin (15 mg/kg per day) perioperatively, and doxofylline (15 mg/kg per day) and ipratropium bromide solution (200 ?g) were administrated postoperatively. Mechanical ventilation parameters, pulmonary surfactant-related protein (SP-B), and cytokines were evaluated after induction of anesthesia and 30 minutes, 24 hours, and 48 hours after CPB.

Results: At the end of CPB, all PaO2/FiO2 values in Group 2 were higher than those in Group 1. Postoperative SP-B levels in Group 1 decreased significantly compared to the baseline value (P < .05). There was no significant difference in hospitalization time between both groups, but both mechanical ventilation time and intensive care unit time of infants in Group 2 were significantly shorter than those in group 1 (P < .05).

Conclusions:These findings indicate that high-dose mucosolvin has certain protective effects on respiratory functions in infants undergoing heart operations with CPB and that it that has no adverse effects.

References

Cui Q, Zhou H, Zhao R, et al. 2009. The effects of open lung ventilation on respiratory mechanics and haemodynamics in atelectatic infants after cardiopulmonary bypass. J Int Med Res 37:113-20.nFan YZ, Wen ZL. 2009. Efficacy of different dosages of ambroxol hydrochloride in the prevention of neonatal respiratory distress syndrome [in Chinese]. Zhongguo Dang Dai Er Ke Za Zhi 11:771-2.nFarkhutdinov UR, Farkhutdinov RR, Petriakov VV, Farkhutdinov ShU, Mirkhaidarov AM. 2010. Effect of mucolytic therapy on the production of reactive oxygen species in the blood of patients with an exacerbation of chronic obstructive pulmonary disease [in Russian]. Ter Arkh 82:29-32.nFu XM, Yu JL, Liu GX, Deng B. 2004. Comparison of the effect of ambroxol and dexamethasone on the expression of pulmonary surfactant proteins in the fetal rat lungs [in Chinese]. Zhonghua Er Ke Za Zhi 42:450-3.nFujii M, Miyagi Y, Bessho R, Nitta T, Ochi M, Shimizu K. 2010. Effect of a neutrophil elastase inhibitor on acute lung injury after cardiopulmonary bypass. Interact Cardiovasc Thorac Surg 10:859-62.nGastiasoro-Cuesta E, Alvarez-Diaz FJ, Rey-Santano C, Arnaiz-Renedo A, Loureiro-Gonzalez B, Valls-i-Soler A. 2006. Acute and sustained effects of lucinactant versus poractant-alpha on pulmonary gas exchange and mechanics in premature lambs with respiratory distress syndrome. Pediatrics 117:295-303.nHaslam PL, Baker CS, Hughes DA, et al. 1997. Pulmonary surfactant composition early in development of acute lung injury after cardiopulmonary bypass: prophylactic use of surfactant therapy. Int J Exp Pathol 78:277-89.nLi L, Wang LX, Dong YQ. 2010. Effects of tetramethylpyrazine on fractalkine and tumor necrosis factor-alpha expression in patients with chronic pulmonary heart disease [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi 30:373-5.nLaoag-Fernandez JB, Fernandez AM, Maruo T. 2000. Antenatal use of ambroxol for the prevention of infant respiratory distress syndrome. J Obstet Gynaecol Res 26:307-12.nMilot J, Perron J, Lacasse Y, Létourneau L, Cartier PC, Maltais F. 2001. Incidence and predictors of ARDS after cardiac surgery. Chest 119:884-8.nSamir K, Riberi A, Ghez O, Ali M, Metras D, Kreitmann B. 2002. Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable? Eur J Cardiothorac Surg 21:787-93.nSchmalisch G, Wauer RR, Böhme B. 1999. Changes in pulmonary function in preterm infants recovering from RDS following early treatment with ambroxol: results of a randomized trial. Pediatr Pulmonol 27:104-12.nSu X, Wang L, Song Y, Bai C. 2004. Inhibition of inflammatory responses by ambroxol, a mucolytic agent, in a murine model of acute lung injury induced by lipopolysaccharide. Intensive Care Med 30:133-40.nSweet DG, Halliday HL. 1999. Current perspectives on the drug treatment of neonatal respiratory distress syndrome. Paediatr Drugs 1:19-30.nWiktorska JA, Lewinski A, Stuss M, Nowak D, Pietras T, Sewerynek E. 2010. Effects of certain antioxidants on lipid peroxidation process in lung homogenates of L thyroxine-receiving rats. Neuro Endocrinol Lett 31:137-46.nYamaki S, Abe A, Sato K, Takahashi T. 1997. Microatelectasis in patients with secundum atrial septal defect and its relation to pulmonary hypertension. Jpn Circ J 61:384-9.n

Published

2011-08-22

How to Cite

Zhao, K., Wang, W., Zhang, J., Zhao, R., Chen, T., Su, J., Ma, C., & Cui, Q. (2011). Effects of High-Dose Mucosolvin on Lung Functions in Infant Patients with Cardiopulmonary Bypass. The Heart Surgery Forum, 14(4), E227-E231. https://doi.org/10.1532/HSF98.20101165

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