Matsutani Noriyuki, Takase Bonpei, Nogami Yashiro, Ozeki Yuichi, Ishihara Masayuki, Maehara Tadaaki
Department of Surgery II, National Defense Medical College, Tokorozawa, Saitama, Japan.
Shock. 2008 Sep;30(3):250-3. doi: 10.1097/shk.0b013e318162be0a.
Supplemental oxygenation is important in reversible pulmonary failure. To determine whether the peritoneal cavity can be used as a source of "extrapulmonary respiration," we perfused the peritoneal cavity with oxygenated red blood cells (RBCs) and saline, and measured the amount of oxygenation delivered through the peritoneum of dogs under controlled ventilation. Inflow and outflow catheters were placed in the peritoneal cavity and connected to a perfusion circuit. We investigated the safety of this procedure by examining the relationship between intraperitoneal infusion volume and hemodynamic changes in dogs that underwent peritoneal perfusion with oxygenated RBC (n = 6) and with oxygenated saline (n = 6). The controls comprised dogs that underwent a sham operation (n = 6). We found that an intraperitoneal infusion of less than 1,250 mL was hemodynamically safe. Oxygenation levels (PaO2) increased most obviously with an intraperitoneal infusion of oxygenated RBC. The peritoneum can potentially serve as an "artificial lung" in critically ill patients.
补充氧疗在可逆性肺衰竭中很重要。为了确定腹腔是否可作为“肺外呼吸”的来源,我们用氧合红细胞(RBC)和生理盐水灌注腹腔,并在控制通气条件下测量通过犬腹膜输送的氧量。将流入和流出导管置于腹腔内并连接至灌注回路。我们通过检查接受氧合RBC(n = 6)和氧合生理盐水(n = 6)腹腔灌注的犬的腹腔内输注量与血流动力学变化之间的关系,研究了该操作的安全性。对照组为接受假手术的犬(n = 6)。我们发现腹腔内输注少于1250 mL在血流动力学上是安全的。腹腔内输注氧合红细胞时氧合水平(PaO2)升高最为明显。腹膜有可能作为危重症患者的“人工肺”。