Nishimura O
Second Department of Surgery, Nihon University, School of Medicine, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jun;38(6):999-1005.
To remove carbon dioxide in acute respiratory failure, pumpless ECMO (extra-corporeal membrane oxygenation) experiment was carried out using extracapillary blood flow type membrane oxygenator, which was developed by our department and which has many advantages, compact, small priming volume and low pressure drop. The oxygenator is consisted with 17 cm in length, 200 microns in inner diameter, made of polypropylene with micropores. And it has 0.7 m2 of surface area and 60 ml of priming volume. In 14 canines, acute respiratory failure were made by hypoventilation (T.V. = 10 ml/kg, R.R. = 5 times/min). We compared with hypoventilation group (group 1, n = 5) and pumpless ECMO group (group 2, n = 9). Pumpless ECMO circuit is A-V bypass between femoral artery and femoral vein. The following results were obtained. 1. In group 1 severe hypoxia and hypercapnea were observed, and all 5 canines were dead within 4 hours. 2. In group 2 hypoxia and hypercapnea were improved by pumpless ECMO, and 4 in 9 lived for 24 hours. 3. Function in CO2 transfer with the P.H.O. is maintained in satisfactory condition for 24 hours. 4. The oxygenator seems to be available for long-term pumpless ECMO. 5. Degeneration of mitochondria in the acute respiratory failure was observed by electron microscopic examination. 6. Further examinations about the intracellular respiration and metabolism in pumpless ECMO should be needed.
为了去除急性呼吸衰竭中的二氧化碳，使用我们科室研发的具有许多优点（紧凑、预充量小和压降低）的毛细血管外血流型膜式氧合器进行了无泵体外膜肺氧合（ECMO）实验。该氧合器长17厘米，内径200微米，由带微孔的聚丙烯制成。其表面积为0.7平方米，预充量为60毫升。在14只犬中，通过低通气（潮气量 = 10毫升/千克，呼吸频率 = 5次/分钟）造成急性呼吸衰竭。我们将其与低通气组（第1组，n = 5）和无泵ECMO组（第2组，n = 9）进行了比较。无泵ECMO回路是股动脉和股静脉之间的动静脉旁路。获得了以下结果。1. 在第1组中观察到严重缺氧和高碳酸血症，所有5只犬在4小时内死亡。2. 在第2组中，无泵ECMO改善了缺氧和高碳酸血症，9只中有4只存活了24小时。3. 使用该氧合器进行二氧化碳转运的功能在24小时内保持在满意状态。4. 该氧合器似乎可用于长期无泵ECMO。5. 通过电子显微镜检查观察到急性呼吸衰竭中存在线粒体退化。6. 需要对无泵ECMO中的细胞内呼吸和代谢进行进一步检查。
