Oto Takahiro, Calderone Alicia, Pepe Salvatore, Snell Gregory, Rosenfeldt Franklin
Heart and Lung Transplant Unit, The Alfred Hospital, Monash University, Melbourne, Australia.
J Thorac Cardiovasc Surg. 2006 Aug;132(2):413-9. doi: 10.1016/j.jtcvs.2006.04.011.
Lungs from non-heart-beating donors for transplantation require protection against warm ischemic damage. Minimally invasive techniques are required to reduce organ damage during the warm ischemic period because invasive surgical procedures are often not feasible at this time. This study investigated the preservative effect of high-flow endobronchial cooled humidified air during warm ischemia in non-heart-beating donor rat lungs.
Fourteen animals were divided into a Cooling group (n = 7), which received cooled air/saline spray during a 2-hour warm ischemic period, and a Control group (n = 7), which received no cooling. After ischemia the lungs were reperfused on an isolated lung perfusion apparatus.
Endobronchial temperatures in the Cooling and Control groups were 8 degrees C and 36 degrees C at 10 minutes, and 5 degrees C and 35 degrees C at 20 minutes, respectively (P < .0001). Lung core and surface temperatures in the Cooling group were also lower than those in the corresponding Control group (P < .0001). After reperfusion, pulmonary arterial pressure (P = .003) and peak airway pressure (P = .002) were lower in the Cooling group than in the Control group. Higher pulmonary venous PO2 (P = .02), higher adenosine triphosphate levels (P = .01), and lower wet/dry lung weight ratio (P = .003) were seen in the Cooling group compared with the Control group.
High-flow endobronchial cooled humidified air can decrease lung temperature and improve post-ischemic pulmonary function and adenosine triphosphate levels in non-heart-beating donor lungs.
用于移植的非心脏跳动供体的肺需要保护以防止热缺血损伤。由于侵入性外科手术在此期间通常不可行，因此需要采用微创技术来减少热缺血期的器官损伤。本研究调查了高流量支气管内冷却加湿空气在非心脏跳动供体大鼠肺热缺血期间的保护作用。
将14只动物分为冷却组（n = 7）和对照组（n = 7）。冷却组在2小时的热缺血期接受冷却空气/盐水喷雾，对照组不进行冷却。缺血后，在离体肺灌注装置上对肺进行再灌注。
冷却组和对照组在10分钟时的支气管内温度分别为8℃和36℃，在20分钟时分别为5℃和35℃（P <.0001）。冷却组的肺核心温度和表面温度也低于相应的对照组（P <.0001）。再灌注后，冷却组的肺动脉压（P =.003）和气道峰值压（P =.002）低于对照组。与对照组相比，冷却组的肺静脉PO2更高（P =.02），三磷酸腺苷水平更高（P =.01），湿/干肺重量比更低（P =.003）。
高流量支气管内冷却加湿空气可降低非心脏跳动供体肺的温度，改善缺血后肺功能和三磷酸腺苷水平。
