Brederlau Jörg, Muellenbach Ralf, Kredel Markus, Schwemmer Ulrich, Anetseder Martin, Greim Clemens, Roewer Norbert
Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany.
Perfusion. 2006 Dec;21(5):277-84. doi: 10.1177/0267659106074769.
This prospective large-animal study was performed to evaluate the contribution of arterio-venous extracorporeal lung assist (AV-ECLA) to pulmonary gas exchange in a porcine lavage-induced acute lung injury model. Fifteen healthy female pigs, weighing 50.3 +/- 3.8 kg (mean +/- SD), were included. After induction of general anaesthesia and controlled ventilation, an arterial line and a pulmonary artery catheter were inserted. Saline lung lavage was performed until the PaO2 decreased to 51 +/- 16 mmHg. After a stabilization period of 60 min, the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed. Under apnoeic oxygenation, variations of sweep-gas flow were performed every 20 min in order to evaluate the membrane lung's efficacy, in terms of carbon dioxide (CO2) removal and oxygen (O2) uptake. Although AV-ECLA is highly effective in eliminating CO2, if combined with apnoeic oxygenation, normocapnia was not achievable. AV-ECLA's contribution to oxygenation during severe hypoxemia was antagonized by a significant increase in the pulmonary shunt fraction.
本前瞻性大型动物研究旨在评估动静脉体外肺辅助（AV-ECLA）在猪灌洗诱导的急性肺损伤模型中对肺气体交换的贡献。纳入了15只体重为50.3±3.8 kg（均值±标准差）的健康雌性猪。在诱导全身麻醉并进行控制通气后，插入动脉导管和肺动脉导管。进行盐水肺灌洗，直至动脉血氧分压（PaO2）降至51±16 mmHg。在60分钟的稳定期后，对股动脉和静脉进行插管，并置入低阻力膜肺。在无呼吸氧合情况下，每20分钟改变一次扫气流量，以评估膜肺在二氧化碳（CO2）清除和氧气（O2）摄取方面的效能。尽管AV-ECLA在消除CO2方面非常有效，但如果与无呼吸氧合相结合，则无法实现正常碳酸血症。在严重低氧血症期间，AV-ECLA对氧合的贡献因肺分流分数的显著增加而受到拮抗。
