Wei Xufeng, Sanchez Pablo G, Liu Yang, Claire Watkins A, Li Tieluo, Griffith Bartley P, Wu Zhongjun J
Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Cardiac Surgery, Xijing Hospital, Xi'an, People's Republic of China.
Artif Organs. 2016 Nov;40(11):1046-1053. doi: 10.1111/aor.12705. Epub 2016 Apr 18.
Respiratory failure is one of the major causes of mortality and morbidity all over the world. Therapeutic options to treat respiratory failure remain limited. The objective of this study was to evaluate the gas transfer performance of a newly developed miniature portable integrated pediatric pump-lung device (PediPL) with small membrane surface for respiratory support in an acute ovine respiratory failure model. The respiratory failure was created in six adult sheep using intravenous anesthesia and reduced mechanical ventilation at 2 breaths/min. The PediPL device was surgically implanted and evaluated for respiratory support in a venovenous configuration between the right atrium and pulmonary artery. The hemodynamics and respiratory status of the animals during support with the device gas transfer performance of the PediPL were studied for 4 h. The animals exhibited respiratory failure 30 min after mechanical ventilation was reduced to 2 breaths/min, indicated by low oxygen partial pressure, low oxygen saturation, and elevated carbon dioxide in arterial blood. The failure was reversed by establishing respiratory support with the PediPL after 30 min. The rates of O transfer and CO removal of the PediPL were 86.8 and 139.1 mL/min, respectively. The results demonstrated that the PediPL (miniature integrated pump-oxygenator) has the potential to provide respiratory support as a novel treatment for both hypoxia and hypercarbia. The compact size of the PediPL could allow portability and potentially be used in many emergency settings to rescue patients suffering acute lung injury.
呼吸衰竭是全球死亡和发病的主要原因之一。治疗呼吸衰竭的选择仍然有限。本研究的目的是在急性绵羊呼吸衰竭模型中，评估一种新开发的具有小膜面积的微型便携式集成儿科泵肺装置（PediPL）用于呼吸支持的气体交换性能。使用静脉麻醉并将机械通气减至2次/分钟，在6只成年绵羊中造成呼吸衰竭。通过手术植入PediPL装置，并在右心房和肺动脉之间以静脉-静脉配置评估其呼吸支持情况。在使用该装置支持动物的过程中，对其血流动力学和呼吸状态以及PediPL的气体交换性能进行了4小时的研究。在机械通气减至2次/分钟后30分钟，动物出现呼吸衰竭，表现为动脉血氧分压降低、血氧饱和度降低和动脉血二氧化碳升高。30分钟后通过使用PediPL建立呼吸支持使衰竭得到逆转。PediPL的氧输送率和二氧化碳清除率分别为86.8和139.1毫升/分钟。结果表明，PediPL（微型集成泵氧合器）有潜力作为一种治疗低氧血症和高碳酸血症的新方法提供呼吸支持。PediPL的紧凑尺寸使其具有便携性，并有可能在许多紧急情况下用于抢救急性肺损伤患者。
