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Low-Frequency Ventilation During Cardiac Surgery Protects Lung Function

• A clinical trial led by the University of Bristol found that low-frequency ventilation (LFV) during heart valve surgery may protect lung function. • The study demonstrated the feasibility and safety of LFV during heart-lung machine use in patients undergoing heart valve surgery. • Patients receiving LFV showed preserved lung function and improved walking distance compared to those with standard collapsed-lung practice. • LFV also triggered a change in the sRAGE biomarker, potentially paving the way for future lung protection drug development.

A new intervention employing low-frequency ventilation (LFV) to maintain regular lung expansion during heart-lung machine use in heart valve surgery shows promise in protecting lung function and exercise capacity post-operation. The University of Bristol-led clinical trial, published in the Journal of the American Heart Association, suggests a feasible, safe, and effective approach that could benefit numerous patients undergoing similar cardiac surgeries.

Preserving Lung Function During Cardiac Surgery

The randomized controlled trial investigated whether maintaining lung expansion with LFV during heart-lung machine use in heart valve surgery patients could improve postoperative lung function and exercise ability. The study also assessed the feasibility and safety of LFV, its impact on surgery, and potential biomarkers of lung injury for future drug development.

Study Design and Results

Sixty-three patients with severe mitral or aortic valve disease were randomized to either LFV or standard care (collapsed lungs). The average patient age was 66.8 years, with 30% being women. Participants were followed for six to eight weeks post-discharge. Results indicated that LFV was feasible and safe during heart valve surgery. Furthermore, patients in the LFV group exhibited preserved lung function and walked significantly longer during the 6-minute walking test before discharge compared to the control group.

Biomarker Identification

Notably, LFV induced a change in the sRAGE biomarker, potentially offering a target for future lung protection drug development. According to Professor Raimondo Ascione, "Our randomized clinical phase II trial has found using low frequency ventilation (LFV) during heart-lung machine in the targeted heart valve surgery patients is viable, safe and effective."

Future Implications

Professor Ascione added that the next step involves a larger national phase III trial involving a greater number of patients with severe heart valve disease. If the results are confirmed, LFV could become routine practice, leading to significant cost savings. Future studies on sRAGE might also facilitate the development of novel lung protection drugs for patients undergoing cardiac surgery with a heart-lung machine.
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Reference News

[1]
New intervention to protect lungs during cardiac surgery, feasible, safe, and effective, study finds
medicalxpress.com · Sep 28, 2024

A University of Bristol-led trial found that low frequency ventilation (LFV) during heart-lung machine use in heart valv...

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