Zhang Ruoyu, Bures Maximilian, Höffler Klaus, Jonigk Danny, Haverich Axel, Krueger Marcus
Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Department of Pathology, Hannover Medical School, Hannover, Germany.
Thorac Cardiovasc Surg. 2014 Dec;62(8):705-9. doi: 10.1055/s-0034-1389272. Epub 2014 Sep 10.
Controversies surrounding the efficacy of sealants against alveolar air leak (AAL) are abundant in the literature. We sought to test the widely used sealants, TachoSil (Takeda Pharmaceutical Company Limited, Osaka, Japan) and BioGlue (CryoLife Europa Ltd., Surrey, United Kingdom) in an in vitro model. Materials and
After creation of a focal superficial defect (40 × 25 mm) in swine lungs (n=40), AAL was assessed with increasing inspired tidal volume (TVi). Upon sealant application in a randomized order, AAL was assessed in the same way until sealant burst.
At TVi =400, 500, 600, and 700 mL, BioGlue achieved sealing in 19, 19, 16, and 14 tests, while TachoSil sealed in 19, 14, 4, and no test, respectively. The maximally tolerated pressure of BioGlue was higher than TachoSil (40.3 ± 3.0 vs. 36.0 ± 4.9 cm H2O, p=0.003). Cohesive and adhesive failures were found in 10 and 1 tests of BioGlue, respectively, while all burst failures of TachoSil were adhesive. Concerning elasticity, TachoSil allowed more expansion of the covered defect than BioGlue (6.3 ± 3.9 vs. 1.4 ± 1.0 mm, p<0.001).
The tested sealants demonstrated high sealing efficacy. While BioGlue was superior in resisting higher ventilation pressure, TachoSil possessed better elasticity.
关于密封剂预防肺泡漏气（AAL）疗效的争议在文献中大量存在。我们试图在体外模型中测试广泛使用的密封剂TachoSil（日本大阪武田制药有限公司）和BioGlue（英国萨里CryoLife Europa有限公司）。
在猪肺（n = 40）上制造一个局灶性浅表缺损（40×25 mm）后，随着吸气潮气量（TVi）增加评估肺泡漏气情况。以随机顺序应用密封剂后，以相同方式评估肺泡漏气情况，直至密封剂破裂。
在TVi = 400、500、600和700 mL时，BioGlue在19、19、16和14次测试中实现了密封，而TachoSil分别在19、14、4次测试中实现了密封，在TVi = 700 mL时未实现密封。BioGlue的最大耐受压力高于TachoSil（40.3±3.0 vs. 36.0±4.9 cm H2O，p = 0.003）。BioGlue分别在10次和1次测试中出现内聚性和粘附性失效，而TachoSil的所有破裂失效均为粘附性失效。关于弹性，TachoSil允许覆盖缺损的扩张比BioGlue更大（6.3±3.9 vs. 1.4±1.0 mm，p<0.001）。
所测试的密封剂显示出较高的密封效果。虽然BioGlue在抵抗更高通气压力方面更具优势，但TachoSil具有更好的弹性。
