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在啮齿动物中开展双重血液滤过加体外循环。

Developing dual hemofiltration plus cardiopulmonary bypass in rodents.

作者信息

Shinozaki Koichiro, Lampe Joshua W, Wang Chih-Hsien, Yin Tai, Kim Junhwan, Oda Shigeto, Hirasawa Hiroyuki, Becker Lance B

机构信息

Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA; Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan.

Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA.

出版信息

J Surg Res. 2015 May 1;195(1):196-203. doi: 10.1016/j.jss.2014.12.004. Epub 2014 Dec 9.

Abstract

BACKGROUND

Emerging therapies for prolonged cardiac arrest (CA) include advanced circulatory interventions like emergency cardiopulmonary bypass (ECPB) and continuous venovenous hemofiltration (CVVHF). However, preclinical studies are limited because of the absence of a practical method of using CVVHF along with ECPB in rodents.

METHODS

We modified a CA model with ECPB resuscitation to include the CVVHF circuit. Adult rats were cannulated via the femoral artery or vein and the jugular vein for the ECPB circuit. A new circuit for CVVHF was added to allow ECPB and CVVHF to be started simultaneously. CVVHF blood flow at 3 mL/min could be controlled with a screw clamp during ECPB. After cessation of ECPB, the CVVHF flow was maintained using a roller pump. The filtration rate was controlled at 40 mL/h/kg in the standard volume of CVVHF and 120 mL/h/kg in the high volume (HV) of CVVHF. The driving force of hemofiltration was evaluated by monitoring transmembrane pressure and filter clearance (FCL).

RESULTS

Transmembrane pressure in both groups was stable for 6 h throughout CVVHF. FCL of blood urea nitrogen and potassium in the standard volume group was significantly less than the HV group (P < 0.01). FCL of blood urea nitrogen and potassium was stable throughout the CVVHF operation in both groups.

CONCLUSIONS

We developed a method of CVVHF along with ECPB in rodents after CA. We further demonstrated the ability to regulate both standard and HV filtration rates.

摘要

背景

用于延长心脏骤停(CA)时间的新兴疗法包括高级循环干预措施,如紧急体外循环(ECPB)和持续静脉-静脉血液滤过(CVVHF)。然而,由于缺乏在啮齿动物中同时使用CVVHF和ECPB的实用方法,临床前研究受到限制。

方法

我们对采用ECPB复苏的CA模型进行了改良,纳入了CVVHF回路。成年大鼠通过股动脉或静脉以及颈静脉插管建立ECPB回路。增加了一个新的CVVHF回路,使ECPB和CVVHF能够同时启动。在ECPB期间,可通过螺旋夹控制CVVHF的血流量为3 mL/min。ECPB停止后,使用滚轴泵维持CVVHF流量。在标准CVVHF体积下,滤过率控制为40 mL/h/kg,在高容量(HV)CVVHF下为120 mL/h/kg。通过监测跨膜压和滤器清除率(FCL)评估血液滤过的驱动力。

结果

在整个CVVHF过程中,两组的跨膜压在6小时内保持稳定。标准体积组血尿素氮和钾的FCL显著低于HV组(P < 0.01)。两组在整个CVVHF操作过程中血尿素氮和钾的FCL均保持稳定。

结论

我们开发了一种在CA后啮齿动物中联合使用CVVHF和ECPB的方法。我们进一步证明了调节标准和HV滤过率的能力。

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