Isobe J, Mizuno H, Matsunobe S, Shimizu Y, Ikada Y, Kishida A
Department of Experimental Surgery, Kyoto University, Japan.
ASAIO Trans. 1989 Jul-Sep;35(3):638-9. doi: 10.1097/00002480-198907000-00153.
To perform low blood flow extracorporeal CO2 removal (ECCO2R), the authors developed a device for extracorporeal circulation (ECC) equipped with a dialyzer for the elimination of CO2 as bicarbonate. The major problem with this method was the decrease in blood pH. To control blood pH and clarify the limit of CO2 elimination using this method, a study with apneic dogs was performed. Six anesthetized mongrel dogs were intubated and paralyzed with a muscle relaxant. Vascular access was achieved with a venovenous bypass. ECC was initiated under apneic oxygenation (100% O2, 10 cm H2O continuous airway pressure), and the CO2 concentration in the airway outlet was measured. The CO2 was converted to bicarbonate using systemic infusion of trihydroxy-methylamino methane (THAM), and the generated bicarbonate was removed by hemodialysis. Blood flow rate in the ECC was 15 ml/kg/min, and the duration of ECC was 5 hr. During ECC, the hemodynamic parameters of the dogs were stable, and the PaCO2 remained at about 90 mmHg with a PaO2 above 350 mmHg; CO2 elimination from the airway was negligible.
为了进行低血流量体外二氧化碳清除（ECCO2R），作者开发了一种体外循环（ECC）装置，该装置配备了用于以碳酸氢盐形式清除二氧化碳的透析器。这种方法的主要问题是血液pH值下降。为了控制血液pH值并明确使用该方法清除二氧化碳的限度，对窒息犬进行了一项研究。6只麻醉的杂种犬经气管插管并用肌肉松弛剂使其麻痹。通过静脉-静脉旁路实现血管通路。在窒息氧合（100%氧气，10 cm H2O持续气道压力）下启动ECC，并测量气道出口处的二氧化碳浓度。通过全身输注三羟甲基氨基甲烷（THAM）将二氧化碳转化为碳酸氢盐，并通过血液透析清除生成的碳酸氢盐。ECC中的血流量为15 ml/kg/min，ECC持续时间为5小时。在ECC期间，犬的血流动力学参数稳定，动脉血二氧化碳分压（PaCO2）保持在约90 mmHg，动脉血氧分压（PaO2）高于350 mmHg；气道二氧化碳清除可忽略不计。
