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Liposome‐Encapsulated Hemoglobin Accelerates Bronchial Healing After Pneumonectomy in the Rat With or Without Preoperative Radiotherapy
Author(s) -
Takeichi Haruka,
Kawaguchi Akira T.,
Murayama Chieko,
Koike Junki,
Iwazaki Masayuki
Publication year - 2014
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12278
Subject(s) - saline , medicine , pneumonectomy , anastomosis , lung , hemoglobin , wound healing , infiltration (hvac) , surgery , radiation therapy , anesthesia , nuclear medicine , thermodynamics , physics
Abstract Liposome‐encapsulated hemoglobin ( LEH ) has been reported to accelerate wound healing in the stomach and skin in an experimental setting. LEH was tested in bronchial anastomotic healing after radiation and pneumonectomy in the rat. S prague‐ D awley rats ( n = 61) received preoperative radiation (20 Gy ) to the chest and underwent left pneumonectomy with bronchial stump closure using the S weet method 4 days later, when they were randomized to receive intravenous infusion of LEH with high O 2 affinity ( P 50 O 2 = 17 mm H g, 10 mL /kg, n = 32) or saline ( n = 29). Additional rats ( n = 18) were treated in the same way without preoperative radiation. Bronchial anastomotic healing was evaluated 2 days after surgery by determining the bursting pressure and infiltration of neutrophils, monocytes, and macrophages. Bronchial bursting pressure was elevated in the rats receiving LEH both in the unirradiated group ( LEH 212 ± 78 vs. saline 135 ± 63 mm H g, P < 0.05) and in rats with preoperative radiation ( LEH 162 ± 48 vs. saline 116 ± 56 mm H g, P < 0.01). Moreover, the percentage of rats with bursting pressure <100 mm H g tended to be smaller in the unirradiated group ( LEH 1/9 [11.1%] vs. saline 4/9 [44.4%], NS ) and was significantly reduced in irradiated animals ( LEH 3/32 [9.4%] vs. saline 11/29 [38%], P < 0.05). There were no morphological differences except for macrophage infiltration to the anastomotic area, which was significantly prominent in the LEH ‐treated rats ( P < 0.05) regardless of the presence or absence of preoperative irradiation ( IR ). The results suggest that LEH with high O 2 affinity may improve mechanical strength and morphological findings in bronchial anastomosis in rats regardless of the presence or absence of preoperative IR . The irradiated rats later treated with LEH had equivalent or better bronchial healing than that of saline‐treated naïve animals undergoing pneumonectomy alone.