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在猪静脉-静脉体外膜肺氧合模型中快速放置双腔双腔静脉导管。

Rapid placement of bicaval dual-lumen catheter in a swine model of venovenous ECMO.

作者信息

Hayes Don, Yates Andrew R, Duffy Victoria L, Tobias Joseph D, Mansour Heidi M, Olshove Vincent F, Preston Thomas J

机构信息

1Section of Pulmonary Medicine, Nationwide Children's Hospital , Columbus, Ohio , USA .

出版信息

J Invest Surg. 2014 Feb;27(1):27-31. doi: 10.3109/08941939.2013.826311. Epub 2013 Aug 26.

DOI:10.3109/08941939.2013.826311
PMID:23978283
Abstract

BACKGROUND

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) applied through a single site with a bicaval dual-lumen (BCDL) catheter is a growing method of treatment of acute respiratory failure, thus animal models for research purposes are needed. We describe a rapid technique for the placement of the BCDL catheter for single-site VV ECMO in swine.

DESIGN

Prior to the application of single-site VV ECMO model with common crossbred piglets, BCDL catheters were placed using anatomical landmarks. Transthoracic echocardiography (TTE) with color Doppler was used to determine catheter placement. Final determination of catheter placement was confirmed by necropsy. Arterial blood gas and hemodynamic parameters were recorded at baseline and then hourly. The values are mean ± SD.

RESULTS

Using anatomical landmarks by positioning the BCDL catheter tip approximately 6.5 cm distal to the tip of the manubrium, cannulation was easily accomplished in five piglets with no positional adjustments of the catheter required. Cannula placement was confirmed with both TTE color Doppler and necropsy. Respiratory support was achieved with baseline and hourly measurements of pH 7.45 ± 0.03, 7.44 ± 0.07, 7.46 ± 0.05, 7.47 ± 0.06 (p = NS); PO2 86 ± 30 mmHg, 98 ± 30 mmHg, 94 ± 40 mmHg, and 79 ± 30 mmHg (p = NS); and PCO2 43 ± 3 mmHg, 44 ± 8 mmHg, 38 ± 5 mmHg, and 40 ± 4 mmHg (p = NS).

CONCLUSIONS

Using anatomical landmarks for the placement of the BCDL catheter was rapid and effective in a swine model of VV ECMO, resulting in improved time efficiency for research.

摘要

背景

通过使用双腔双腔静脉(BCDL)导管在单一部位进行静脉-静脉(VV)体外膜肺氧合(ECMO)是治疗急性呼吸衰竭日益常用的方法,因此需要用于研究目的的动物模型。我们描述了一种在猪中快速放置用于单部位VV ECMO的BCDL导管的技术。

设计

在对普通杂交仔猪应用单部位VV ECMO模型之前,利用解剖标志放置BCDL导管。使用彩色多普勒经胸超声心动图(TTE)确定导管位置。通过尸检确认导管位置的最终确定。在基线时及之后每小时记录动脉血气和血流动力学参数。数值为平均值±标准差。

结果

通过利用解剖标志将BCDL导管尖端置于胸骨柄尖端远端约6.5 cm处,五只仔猪均轻松完成插管,无需对导管进行位置调整。通过TTE彩色多普勒和尸检均确认了插管位置。通过基线及每小时测量,pH值分别为7.45±0.03、7.44±0.07、7.46±0.05、7.47±0.06(p=无显著性差异);PO2分别为86±30 mmHg、98±30 mmHg、94±40 mmHg和79±30 mmHg(p=无显著性差异);PCO2分别为43±3 mmHg、44±8 mmHg、38±5 mmHg和40±4 mmHg(p=无显著性差异),实现了呼吸支持。

结论

在VV ECMO猪模型中,利用解剖标志放置BCDL导管快速有效,提高了研究的时间效率。

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