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经主动脉顺行性细胞内晶体灌注与顺行/逆行性心肌麻痹用于猪心脏保存的比较

Pig heart preservation with antegrade intracellular crystalloid versus antegrade/retrograde miniplegia.

作者信息

Portilla-de Buen Eliseo, Leal Caridad, García-Martínez David, Cornejo Agustín, Zepeda Alonso, Aburto Enrique

机构信息

Surgical Research Division, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México.

出版信息

J Extra Corpor Technol. 2011 Sep;43(3):130-6.

Abstract

Both histidine-tryptophan-ketoglutarate (HTK) solution and Braile miniplegia are commercially available and used with high success. The objective of this work was to compare the effects of both strategies in an animal model. Twelve pigs were divided into control, HTK, or Braile groups using a model of controlled global cardiac ischemia/reperfusion under cardiopulmonary bypass with 1 hour heart ischemia followed by 2 hour reperfusion. No significant differences were found over time or between groups for heart rate, arrhythmia, number of defibrillations required, blood gases, myocardial lactate production, myocardial oxygen consumption, nor coronary flow index. The Braile strategy was associated with a lower 120 minute postreperfusion coronary vascular resistance with higher water content, leukocyte infiltration, and oxidative damage compared with controls. Drainage of HTK solution to the venous return was followed by higher potassium and lower sodium blood concentrations. One-hour heart preservation with HTK or Braile systems followed by 2 hour reperfusion both allow for acceptable preservation of the healthy pig myocardium. Maneuvers such as leukocyte filtration or hemofiltration may further improve these conditions.

摘要

组氨酸-色氨酸-酮戊二酸(HTK)溶液和布赖尔小型麻痹法在市面上均可买到且使用成功率很高。这项工作的目的是在动物模型中比较这两种策略的效果。使用体外循环下控制性全心缺血/再灌注模型,将12头猪分为对照组、HTK组或布赖尔组,心脏缺血1小时,随后再灌注2小时。在心率、心律失常、所需除颤次数、血气、心肌乳酸生成、心肌氧消耗或冠状动脉血流指数方面,随时间推移或组间均未发现显著差异。与对照组相比,布赖尔策略与再灌注后120分钟时较低的冠状动脉血管阻力相关,同时含水量、白细胞浸润和氧化损伤更高。将HTK溶液引流至静脉回流后,血钾浓度升高,血钠浓度降低。用HTK或布赖尔系统进行1小时心脏保存,随后再灌注2小时,均可使健康猪心肌得到可接受的保存。白细胞过滤或血液滤过等操作可能会进一步改善这些情况。

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