Skoog David J, Pohlmann Joshua R, Demos David S, Scipione Christopher N, Iyengar Amit, Schewe Rebecca E, Suhaib Ahmed B, Koch Kelly L, Cook Keith E
From the *Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan; †Department of Surgery, University of Michigan, Ann Arbor, Michigan; and ‡Department of General Surgery, Henry Ford Health System, Detroit, Michigan.
ASAIO J. 2017 Sep/Oct;63(5):644-649. doi: 10.1097/MAT.0000000000000627.
The compliant thoracic artificial lung (cTAL) has been studied in acute in vivo and in vitro experiments. The cTAL's long-term function and potential use as a bridge to lung transplantation are assessed presently. The cTAL without anticoagulant coatings was attached to sheep (n = 5) via the pulmonary artery and left atrium for 14 days. Systemic heparin anticoagulation was used. Compliant thoracic artificial lung resistance, cTAL gas exchange, hematologic parameters, and organ function were recorded. Two sheep were euthanized for nondevice-related issues. The cTAL's resistance averaged 1.04 ± 0.05 mmHg/(L/min) with no statistically significant increases. The cTAL transferred 180 ± 8 ml/min of oxygen with 3.18 ± 0.05 L/min of blood flow. Except for transient surgical effects, organ function markers were largely unchanged. Necropsies revealed pulmonary edema and atelectasis but no other derangements. Hemoglobin levels dropped with device attachment but remained steady at 9.0 ± 0.1 g/dl thereafter. In a 14 day experiment, the cTAL without anticoagulant coatings exhibited minimal clot formation. Sheep physiology was largely unchanged except for device attachment-related hemodilution. This suggests that patients treated with the cTAL should not require multiple blood transfusions. Once tested with anticoagulant coatings and plasma resistant gas exchange fiber, the cTAL could serve as a bridge to transplantation.
顺应性胸腔人工肺（cTAL）已在急性体内和体外实验中进行了研究。目前正在评估cTAL的长期功能及其作为肺移植桥梁的潜在用途。将未涂抗凝剂的cTAL通过肺动脉和左心房连接到绵羊（n = 5）身上，持续14天。采用全身肝素抗凝。记录顺应性胸腔人工肺阻力、cTAL气体交换、血液学参数和器官功能。两只绵羊因与设备无关的问题被安乐死。cTAL的阻力平均为1.04±0.05 mmHg/（L/min），无统计学意义上的显著增加。cTAL以3.18±0.05 L/min的血流量输送180±8 ml/min的氧气。除了短暂的手术影响外，器官功能指标基本未变。尸检显示有肺水肿和肺不张，但无其他紊乱情况。血红蛋白水平在连接设备后下降，但此后稳定在9.0±0.1 g/dl。在为期14天的实验中，未涂抗凝剂的cTAL形成的血栓极少。除了与设备连接相关的血液稀释外，绵羊的生理状况基本未变。这表明接受cTAL治疗的患者不应需要多次输血。一旦用抗凝涂层和抗血浆气体交换纤维进行测试，cTAL可作为移植的桥梁。
