Division of Neonatology, Department of Pediatrics, 525 New Hillman Bldg., 619 South 19th Street, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Pediatr Res. 2009 Dec;66(6):671-6. doi: 10.1203/PDR.0b013e3181bbbf7a.
Respiratory failure is a major contributor to mortality and morbidity in newborn infants. The lung assist device (LAD) is a novel gas exchange device that supplements mechanical ventilation. The objective is to test the effect of the LAD on pulmonary histopathology in juvenile piglets with acute lung injury caused by saline lung lavage (SLL) followed by intermittent mandatory ventilation (IMV). Three- to 4-wk-old piglets were randomized to no intervention (control group), SLL alone (SLL group), SLL + IMV (IMV group), or SLL + IMV + LAD (LAD group) (n = 6 per group). The carotid artery and jugular vein were cannulated and an arteriovenous circuit completed, and the LAD was inserted into this circuit. Gas exchange via the LAD was initiated by passage of 100% oxygen over the blood-carrying hollow fibers of the LAD. Hemodynamic variables were recorded. Mechanical ventilation was systematically weaned. Lung histology was scored by two observers masked to treatment group. There were no differences in hemodynamic variables between the study groups. There was a significant increase in the total lung injury score in the IMV group compared with the LAD group. The novel pumpless low-resistance LAD has shown feasibility and potential to decrease ventilator-induced lung injury in a juvenile animal model.
呼吸衰竭是导致新生儿死亡率和发病率的主要原因之一。肺辅助装置（LAD）是一种新型的气体交换装置，可补充机械通气。本研究旨在通过盐水肺灌洗（SLL）后间歇强制通气（IMV），检测 LAD 对急性肺损伤幼年猪的肺组织病理学的影响。将 3 至 4 周龄的仔猪随机分为无干预（对照组）、单独 SLL（SLL 组）、SLL+IMV（IMV 组）或 SLL+IMV+LAD（LAD 组）（每组 6 只）。对颈动脉和颈静脉进行了插管并建立了动静脉回路，然后将 LAD 插入该回路中。通过 100%氧气流经 LAD 的载血中空纤维来开始通过 LAD 进行气体交换。记录血流动力学变量。有创机械通气被系统地脱机。肺组织学评分由对治疗组不知情的两位观察者进行。研究组之间的血流动力学变量没有差异。与 LAD 组相比，IMV 组的总肺损伤评分显著增加。新型无泵低阻力 LAD 已显示出在幼年动物模型中降低呼吸机相关性肺损伤的可行性和潜力。
