小儿肺衰竭病理生理学模型的开发。

Development of a Model of Pediatric Lung Failure Pathophysiology.

作者信息

Trahanas John M, Alghanem Fares, Ceballos-Muriel Catalina, Hoffman Hayley R, Xu Alice, Deatrick Kristopher B, Cornell Marie S, Rojas-Pena Alvaro, Bartlett Robert H, Hirschl Ronald B

机构信息

From the *Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan; †Department of Surgery, Columbia University Medical Center, New York, New York; ‡Department of Surgery, Universidad el Bosque - Escuela Colombiana de Medicina, Bogota, Colombia; §Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; ¶Department of Surgery, Section of Transplant Surgery, University of Michigan Health Systems, Ann Arbor, Michigan; and ‖Department of Surgery, Section of Pediatric Surgery, University of Michigan Health Systems, Ann Arbor, Michigan.

出版信息

ASAIO J. 2017 Mar/Apr;63(2):216-222. doi: 10.1097/MAT.0000000000000463.

DOI:10.1097/MAT.0000000000000463

PMID:27832003

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5325792/

Abstract

A pediatric artificial lung (PAL) is under development as a bridge to transplantation or lung remodeling for children with end-stage lung failure (ESLF). To evaluate the efficiency of a PAL, a disease model mimicking the physiologic derangements of pediatric ESLF is needed. Our previous right pulmonary artery (rPA) ligation model (rPA-LM) achieved that goal, but caused immediate mortality in nearly half of the animals. In this study, we evaluated a new technique of gradual postoperative right pulmonary artery occlusion using a Rummel tourniquet (rPA-RT) in seven (25-40 kg) sheep. This technique created a stable model of ESLF pathophysiology, characterized by high alveolar dead space (58.0% ± 3.8%), pulmonary hypertension (38.4 ± 2.2 mm Hg), tachypnea (79 ± 20 breaths per minute), and intermittent supplemental oxygen requirement. This improvement to our technique provides the necessary physiologic derangements for testing a PAL, whereas avoiding the problem of high immediate perioperative mortality.

摘要

一种小儿人工肺（PAL）正在研发中，作为终末期肺衰竭（ESLF）儿童移植或肺重塑的桥梁。为了评估PAL的效率，需要一种模拟小儿ESLF生理紊乱的疾病模型。我们之前的右肺动脉（rPA）结扎模型（rPA-LM）实现了这一目标，但在近一半的动物中导致了即刻死亡。在本研究中，我们评估了一种使用鲁梅尔止血带（rPA-RT）在七只（25-40千克）绵羊中进行术后右肺动脉逐渐闭塞的新技术。该技术创建了一个稳定的ESLF病理生理学模型，其特征为高肺泡死腔（58.0%±3.8%）、肺动脉高压（38.4±2.2毫米汞柱）、呼吸急促（每分钟79±20次呼吸）以及间歇性补充氧气需求。我们技术的这种改进为测试PAL提供了必要的生理紊乱，同时避免了围手术期即刻高死亡率的问题。