Schmid Christof, Philipp Alois, Hilker Michael, Arlt Matthias, Trabold Benedikt, Pfeiffer Michael, Schmid Franz-Xaver
Department of Cardiothoracic Surgery, University Hospital Regensburg, Germany.
Ann Thorac Surg. 2008 Apr;85(4):1202-5. doi: 10.1016/j.athoracsur.2007.12.032.
There is no mechanical device available to support patients with end-stage lung failure for weeks and months until appropriate donor organs for lung transplantation are available.
In a 38-year-old female patient with primary pulmonary hypertension a paracorporeal artificial lung (PAL) system was placed parallel to the pulmonary circulation with connections to the pulmonary artery and to the left atrium. The key component of the PAL was a low-resistance membrane oxygenator.
After institution, the PAL had a blood flow of 3.5 L/min and created a PaO(2)/fraction of inspired oxygen ratio of 270, while the oxygenator was provided with oxygen 3 L/min. The pulmonary artery pressure declined by almost 50%. The PAL worked well over 62 days until appropriate donor lungs were available. With resuming more physical activity, an increased flow through the native lung augmented the fraction of unsaturated blood arriving at the left atrium, which mandated increasing oxygen flow to the PAL.
The data obtained with this case encourage further research into PAL systems, which may hopefully serve as a bridge to lung transplant device in appropriate patients in the future.
目前没有机械装置可用于在数周或数月内支持终末期肺衰竭患者，直至获得合适的肺移植供体器官。
在一名38岁的原发性肺动脉高压女性患者中，将体外人工肺（PAL）系统与肺循环并行放置，连接至肺动脉和左心房。PAL的关键组件是一个低阻力膜式氧合器。
植入后，PAL的血流量为3.5升/分钟，动脉血氧分压/吸入氧分数比值为270，同时向氧合器提供3升/分钟的氧气。肺动脉压力下降了近50%。PAL在62天内运行良好，直至获得合适的供体肺。随着体力活动的增加，通过天然肺的血流量增加，到达左心房的未饱和血比例增加，这就要求增加向PAL的氧气流量。
该病例获得的数据鼓励对PAL系统进行进一步研究，有望在未来为合适的患者作为肺移植的过渡装置。
