Differential effects of inhaled and intravenous sildenafil in the prevention of the pulmonary endothelial dysfunction due to cardiopulmonary bypass

J Cardiovasc Pharmacol. 2008 Jan;51(1):11-7. doi: 10.1097/FJC.0b013e3181598279.

Abstract

The objective of the present study was to evaluate the effects of inhaled and intravenous sildenafil on the pulmonary endothelium-dependent relaxations, the hemodynamic profile and oxygenation after cardiopulmonary bypass. Five groups of Landrace swine were compared: 1) control; 2) cardiopulmonary bypass: 90 min of normothermic cardiopulmonary bypass; 3) precardiopulmonary bypass sildenafil nebulization; 4) postcardiopulmonary bypass sildenafil nebulization; 5) intravenous sildenafil administration prior to cardiopulmonary bypass. All groups underwent a 60-min period of pulmonary reperfusion after cardiopulmonary bypass. Vascular reactivity of second-degree pulmonary arteries was evaluated in response to acetylcholine and bradykinin. Cardiopulmonary bypass caused a significant decrease in endothelium-dependent relaxations to both agonists; this dysfunction was prevented by administration of sildenafil, both intravenous and inhaled (P < 0.05). Both administration routes prevented the significant increase in mean pulmonary arterial pressure with a safe hemodynamic profile. Moreover, intravenous and inhaled sildenafil after cardiopulmonary bypass also prevented the increase in alveoloarterial gradient (P < 0.05). Both sildenafil formulations of administration prevent the occurrence of pulmonary endothelial dysfunction. Depending on the administration moment and the route, the administration of sildenafil improves the hemodynamic profile and post-cardiopulmonary bypass oxygenation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcholine
  • Administration, Inhalation
  • Animals
  • Blood Pressure / drug effects
  • Bradykinin
  • Cardiopulmonary Bypass / adverse effects*
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Female
  • Hemodynamics / drug effects
  • Injections, Intravenous
  • Lung Diseases / etiology
  • Lung Diseases / physiopathology
  • Lung Diseases / prevention & control*
  • Male
  • Piperazines / administration & dosage
  • Piperazines / pharmacology*
  • Pulmonary Artery / drug effects
  • Pulmonary Artery / physiopathology
  • Purines / administration & dosage
  • Purines / pharmacology
  • Sildenafil Citrate
  • Sulfones / administration & dosage
  • Sulfones / pharmacology*
  • Swine
  • Vasodilation / drug effects
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / pharmacology*

Substances

  • Piperazines
  • Purines
  • Sulfones
  • Vasodilator Agents
  • Sildenafil Citrate
  • Acetylcholine
  • Bradykinin