Cho Jeong Su, Kim Yeong Dae, Shin Nari, Lee Chang Hun, Cho Sukki, Jheon Sanghoon
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Republic of Korea.
Exp Lung Res. 2013 Feb;39(1):32-8. doi: 10.3109/01902148.2012.747573. Epub 2012 Dec 5.
Despite advances in critical care, more effective methods of systemic oxygenation in patients with acute lung injury or acute respiratory distress syndrome are needed. The goal of this study was to determine if it is possible to increase systemic oxygenation by transpleural perfusion with oxygenated perfluorocarbon in animals with induced acute lung injury.
Eighteen Sprague-Dawley rats were intubated, and acute lung injury was induced by aspiration of 0.1N HCl (1 mL/kg) through the tracheal tube. Inflow and outflow tubes were placed in the thoracic cavity and connected to a perfusion circuit containing a roller pump, warmer, and oxygenator. Rats in group I were not treated after aspiration of HCl, those in group II were perfused with oxygenated saline, and those in group III were perfused with oxygenated perfluorocarbon. Arterial blood gases were collected every 30 minutes for 180 minutes. At the last step of the experiments, pathological examination of the lungs and parietal pleura was performed.
PaO(2) in group III was significantly higher than that in group I or II. PaCO(2) in group III was significantly lower than that in the other two groups. Histological examination showed relatively well-delineated zones of inflammation-free coagulative necrosis of lung parenchyma in all groups.
Transpleural perfusion with oxygenated perfluorocarbon in an animal model of induced acute lung injury resulted in a significant increase in systemic oxygenation and depletion of systemic carbon dioxide, and might be a useful method for improving systemic oxygenation in patients with acute lung injury.
尽管重症监护取得了进展,但仍需要更有效的方法来改善急性肺损伤或急性呼吸窘迫综合征患者的全身氧合。本研究的目的是确定在诱导急性肺损伤的动物中,通过经胸膜灌注含氧全氟化碳是否有可能增加全身氧合。
将18只Sprague-Dawley大鼠插管,通过气管导管注入0.1N盐酸(1 mL/kg)诱导急性肺损伤。将流入和流出管置于胸腔内,并连接至包含滚压泵、加热器和氧合器的灌注回路。I组大鼠在注入盐酸后不进行治疗,II组大鼠用含氧盐水灌注,III组大鼠用含氧全氟化碳灌注。每隔30分钟采集动脉血气,共采集180分钟。在实验的最后一步,对肺和壁层胸膜进行病理检查。
III组的动脉血氧分压(PaO₂)显著高于I组或II组。III组的动脉血二氧化碳分压(PaCO₂)显著低于其他两组。组织学检查显示,所有组肺实质均有相对界限清晰的无炎症凝固性坏死区域。
在诱导急性肺损伤的动物模型中,经胸膜灌注含氧全氟化碳可显著增加全身氧合并降低全身二氧化碳水平,可能是改善急性肺损伤患者全身氧合的一种有用方法。