Grady Daniel J, Gentile Michael A, Riggs John H, Cheifetz Ira M
Mission Health System, Asheville, NC.
Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, NC.
Clin Med Insights Circ Respir Pulm Med. 2014 Sep 10;8:11-6. doi: 10.4137/CCRPM.S16760. eCollection 2014.
One of the primary goals of critical care medicine is to support adequate gas exchange without iatrogenic sequelae. An emerging method of delivering supplemental oxygen is intravenously rather than via the traditional inhalation route. The objective of this study was to evaluate the gas-exchange effects of infusing cold intravenous (IV) fluids containing very high partial pressures of dissolved oxygen (>760 mm Hg) in a porcine model.
Juvenile swines were anesthetized and mechanically ventilated. Each animal received an infusion of cold (13 °C) Ringer's lactate solution (30 mL/kg/hour), which had been supersaturated with dissolved oxygen gas (39.7 mg/L dissolved oxygen, 992 mm Hg, 30.5 mL/L). Arterial blood gases and physiologic measurements were repeated at 15-minute intervals during a 60-minute IV infusion of the supersaturated dissolved oxygen solution. Each animal served as its own control.
Five swines (12.9 ± 0.9 kg) were studied. Following the 60-minute infusion, there were significant increases in PaO2 and SaO2 (P < 0.05) and a significant decrease in PaCO2 (P < 0.05), with a corresponding normalization in arterial blood pH. Additionally, there was a significant decrease in core body temperature (P < 0.05) when compared to the baseline preinfusion state.
A cold, supersaturated dissolved oxygen solution may be intravenously administered to improve arterial blood oxygenation and ventilation parameters and induce a mild therapeutic hypothermia in a porcine model.
重症医学的主要目标之一是在不产生医源性后遗症的情况下支持充分的气体交换。一种新兴的补充氧气的方法是静脉输注,而非传统的吸入途径。本研究的目的是在猪模型中评估输注含有极高溶解氧分压(>760mmHg)的冷静脉(IV)液体对气体交换的影响。
对幼年猪进行麻醉并机械通气。每只动物接受冷(13°C)乳酸林格液输注(30mL/kg/小时),该溶液已用溶解氧气体进行过饱和处理(溶解氧39.7mg/L,992mmHg,30.5mL/L)。在60分钟的超饱和溶解氧溶液静脉输注过程中,每隔15分钟重复进行动脉血气和生理测量。每只动物自身作为对照。
研究了5头猪(12.9±0.9kg)。在60分钟输注后,PaO2和SaO2显著升高(P<0.05),PaCO2显著降低(P<0.05),同时动脉血pH相应恢复正常。此外,与输注前的基线状态相比,核心体温显著降低(P<0.05)。
在猪模型中,冷的、超饱和的溶解氧溶液可通过静脉给药改善动脉血氧合和通气参数,并诱导轻度治疗性低温。