No effect of L‐arginine supplementation on pulmonary endothelial dysfunction after cardiopulmonary bypass

Abstract

In the current study L-arginine had no protective effect on the pulmonary endothelium after cardiopulmonary bypass, measured as reactivity to an infusion of acetylcholine.

Pulmonary Perfusion With L-Arginine Ameliorates Post-Cardiopulmonary Bypass Lung Injury in a Rabbit Model

“…Thus, drugs administered via systemic circulation might not effectively enter the lung parenchyma. This might partly explain the negative effect of L-arginine on pulmonary endothelial dysfunction after CPB when administrated systemically in a previous report [12].…”

“…However, the benefit of L-arginine in post-CPB lung injury prevention remains controversial [7,11,12]. Angdin et al found no effect of L-arginine on pulmonary endothelial dysfunction after CPB in a group of 35 adult patients [12]. In contrast, Yang et al showed that L-arginine infusion improved pulmonary surfactant integrity after CPB in animal study [11].…”

“…This hypothesis had been proven in other IR injury models [18,19]. However, the benefit of L-arginine in post-CPB lung injury prevention remains controversial [7,11,12]. Angdin et al found no effect of L-arginine on pulmonary endothelial dysfunction after CPB in a group of 35 adult patients [12].…”

“…However, this hypothesis remained controversial. Angdin et al found no effect of L-arginine on pulmonary endothelial dysfunction after CPB when infused systemically, while Yang et al found better pulmonary surfactant integrity after CPB when L-arginine was infused into the pulmonary circulation [11,12]. Wei et al also reported an improved oxygenation index after CPB when infusing the lungs with a protective solution containing a mixture of L-arginine, aprotinin, and anisodamine [7].…”

“…Recently, pulsatile perfusion has been shown to provide better protection as opposed to continuous perfusion in a piglet model [10]. Besides restoring pulmonary perfusion during CPB, provision of extraneous NO precursor L-arginine had also been proposed to decrease IR injury [7,11,12]. However, this hypothesis remained controversial.…”