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Eur J Cardiothorac Surg 2005;28:594-598
© 2005 Elsevier Science NL

Original articles

Pulmonary intravascular volume can be used for dose calculation in isolated lung perfusion

^a Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
^b Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Antwerp, Belgium
^c Department of Pharmacology and Pathophysiology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands
^d Department of Clinical Chemistry, University Medical Center, Utrecht, the Netherlands
^e Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands

Received 27 April 2005; accepted 20 June 2005.

^* Corresponding author. Address: Nijenheim 62-47, NL-3704 BJ Zeist, The Netherlands. Tel.: +31 30 250 6179. (Email: bvanputte{at}yahoo.com).

Abstract

Introduction: Isolated lung perfusion (ILuP) is an experimental surgical technique for the treatment of pulmonary metastases. Phase I trials showed a wide range in drug lung levels. This may be due to the variance of lung size and pulmonary intravascular volume (PIV). Therefore, we developed a method to assess PIV and investigated the relation of PIV and dry lung weight (DLW). Material and methods: Thirty-two rats of 555±8 and 199±5g underwent left ILuP two, four and eight minutes. Venous effluent was analyzed for haemoglobin, red blood cells (RBC), leucocytes, platelets, albumin and creatinine. PIV was calculated by dividing the product of perfusate volume and post-ILuP parameter by the difference between post-ILuP and pre-ILuP parameter. Results: No significant differences in PIV for all perfusion times were noted between the different variables (P=0.14). Based on haemoglobin (P<0.0009), RBC (P=0.006), leucocytes (P=0.0003), platelets (P=0.017) and creatinine (P=0.003) analysis, PIV was significantly smaller in rats of 199g while PIV/DLW ratio was not significantly different. Conclusion: Because PIV/DLW ratio is independent of body weight, we advocate PIV calculation using haemoglobin and RBC as an excellent parameter for drug dose calculation during ILuP intraoperatively in order to achieve more reproducible local drug levels and higher efficacy.

Key Words: Pulmonary intravascular volume • Isolated lung perfusion • Experimental • Rat model

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