Correlative study of perioperative acute lung injury and TF and TFPI of acute aortic dissection

Abstract

Objective To analyze the correlation of the acute lung injury(ALI) and tissue factor(TF)and tissue factor pathway inhibitor(TFPI) of acute aortic dissection(AAD) in perioperative period.Methods Between October 2012 and December 2013,53 AAD patients had admitted undergone open repairs with general anaesthesia and DHCA.Grouped the cases according to the situation of preoperative ALI:group A(22 cases):ALI occurred in preoperative period,group C(31 cases):ALI did not occur in preoperative period.Demographic data were collected.Multiple perioperative factors including age,gender,BMI,AAD onset time,complications,intake and output,mechanic ventilation time in ICU.PaO2/FiO2 and Levels of TF and TFPI were measured at the 12 h before operation (T1),after anesthesia induction (T2),before the end of the operation (T3),and 12 h after operation(T4) respectively.Statistical analysis was processed by SPSS 17.0 software.Measurement data to normal distribution with.(x) ± s,groups were compared with t test.Skewed normal distribution measurement data to the median between the two groups were compared using Wilcoxon test.Count data do chisquare test.Correlation analysis with multiple linear regression.Results Compare PaO2/FiO2:group A was significantly lower than group C at all time points (P ＜0.05),and PaO2/FiO2 had a gradually decreasing trend throughout the procedure in two groups (P ＜ 0.05).Compare TF and TFPI:group A was significantly higher than group C at all time points in blood and at T2 and T3 in BALF (P ＜ 0.05),and TF and TFPI in blood had a gradually increasing trend throughout the procedure in two groups (P ＜ 0.05).Compare blood loss and mechanic ventilation time in ICU:group A was significantly higher than group C (P ＜ 0.05).TF in blood and PaO2/FiO2 present a negative correlation(r =-0.622,P ＜ 0.001).TF in BALF and PaO2/FiO2 present a negative correlation (r =-0.571,P ＜0.001).Conclusion The AAD patients can be attacked with preoperative ALI.The severity of ALI had a gradually increasing trend throughout the procedure.TF and TFPI had a higher level in AAD patients with preoperative ALI.TFand PaO2/FiO2 present a negative correlation. Key words: Aortia ; Aneurysm, dissection ; Acute lung injury ; Thromboplastine ; TFPI