Effect of inhaled glucocorticoid on acute lung injury and pulmonary dysfunction in patients with complex congenital heart disease with reduced pulmonary blood flow

doi:10.3969/j.issn.1672-5301.2017.03.020

Abstract：Objective To investigate whether inhaled corticosteroids can reduce acute lung injury and improve pulmonary function after cardiopulmonary bypass. Methods Selected all the 36 patients in Wuhan Asia Heart Hospital during 2015-2016 with complex cyanotic congenital heart disease with reduced pulmonary blood flow. All the patients were randomly divided into two groups after underwent radical surgery through cardiopul-monary bypass. The test group was given budesonide 1 mg with basic atomizing drugs,while the control group was given saline 2 ml with basic atomizing drugs. Inhalation equipment,time and dose between them were the same. All the other respiratory management measures and clinical treatment principles were in no difference. Analysis of the main observation indexes comparatively,including invasive ventilator assisting time,non-invasive ventilator as-sisting time,ICU time,hospital stay,pneumonia incidence and mortality. The secondary observation indexes were white blood cell count,procalcitonin,oxygenation index,arterial partial pressure of carbon dioxide and positive end-expiratory pressure in different time post operation. Results The non-invasive ventilator assisting time [(41.00±21.20)h vs(58.44±20.69)h],ICU time[(5.50±2.33)d vs(7.33±2.03)d]and hospital stay[(11.28± 3.80)d vs(14.00±2.54)d]in the experimental group were shorter than that in the control group,with other major indicators no difference. Secondary indexes were superior to the control group in the late obsevating period[eg. Pro-calcitonin in the 7 day after surgery was(1.99±1.39)ng/ml vs(3.58±2.21)ng/ml],but no difference was found in the early stage. Conclusion Application of inhaled glucocorticoids could reduce the postoperative acute lung injury, promote the recovery of pulmonary function and shorten the course of disease in a certain period and certain extent.