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Na+/H+exchange inhibitor cariporide: effects on respiratory dysfunction after cardiopulmonary bypass

Department of Anaesthesiology, University of Luebeck, Germany, eichler{at}medinf.mu-luebeck.de

Matthias JF Bechtel

Department of Cardiothoracic Surgery, University of Luebeck, Germany

Stephan Klaus

Department of Anaesthesiology, University of Luebeck, Germany

Matthias Heringlake

Department of Anaesthesiology, University of Luebeck, Germany

Mario Hernandez

Department of Anaesthesiology, University of Luebeck, Germany

Kai Toerber

Department of Cardiothoracic Surgery, University of Luebeck, Germany

Karl-Friedrich Klotz

Department of Anaesthesiology, University of Luebeck, Germany

Claus Bartels

Department of Cardiothoracic Surgery, University of Luebeck, Germany

The purpose of the present study was to evaluate the potential of the Na⁺/H⁺ exchange inhibitor cariporide to protect the lung from injury after cardiopulmonary bypass (CPB). In a randomized placebo-controlled study, 16 pigs were subjected to CPB for 75 min. Administration of vehicle or cariporide (bolus 180 mg, 40 mg/hour) began 30 min pre-CPB and was continued throughout the protocol. The alveolo-arterial O₂-gradient (AaDO₂), the pulmonary shunt (Qs/Qt), the compliance (Cpl), haemo-dynamic variables and glycerol and water content in lung tissue were measured 10 min before and up to 180 min post-CPB. All animals in the control versus 75% in the cariporide group survived the experiment. At 5 and 60 min post-CPB, the mean AaDO₂ and at 5, 60 and 180 min post-CPB, the mean pulmonary vascular resistance index were higher in the cariporide group (p < 0.05), respectively. More lung water accumulation was found in the cariporide group (p < 0.05). Mean Cpl decreased; the Qs/Qt and glycerol in lung tissue increased without significant intergroup difference. In this model, the inhibitor of the Na⁺/H⁺ antiporter showed no protective effect on lung injury after CPB and might even have harmful effects on pulmonary vascular tone and function.

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