Influence of cardiopulmonary bypass on vascular endothelial cell and effects of intervention therapy

Objective To investigate the injury of vascular endothelial cells during cardiopulmonary bypass (CPB)and the protective effect of Shenfu injection (SFI). Methods Sixty six children with congenital heart disease were ran-domly divided into the treated group (n=33) and the control group (n=33). In the treated group, Shenfu injection (2 ml/kg) was added into cardiopulmonary- bypass circuit priming before CPB.In both groups, arterial blood samples were tak-en at the following time- points: after induction of anesthesia, 30 min after the start of CPB, 5 min, 15 min afterdeclamping of aorta, 2 h after the end of CPB. Tumor necrosis factor- alpha (TNF-α)、soluble thrombomodulin and solu-ble P- selectin were measured by doubled antibodies sandwich enzyme- linked immunosorbent assay. Results Plasmalevels of TNF- α、soluble thrombomodulin and soluble P- selectin between two groups showed no difference before CPBand all increased during and after CPB (P0.01). However, in the treated group, the concentrations of TNF- α、solublethrombomodulin and soluble P- selectin were significantly reduced compared with the control group at 30 min after thestart of CPB, 5 min, 15 min after declamping of aorta, 2h after the end of CPB (P0.05 or P0.01). Conclusion CPBinduced the injury of vascular endothelial cells during surgery for congenital heart disease with CPB. Circuit primingwith Shenfu injection might protect vascular endothelial cells from injury induced CPB.