Takahashi Nozomi, Nakada Taka-Aki, Oda Shigeto
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo, Chiba, 260-8677, Japan.
J Artif Organs. 2018 Dec;21(4):427-434. doi: 10.1007/s10047-018-1058-x. Epub 2018 Jul 6.
We developed a novel system comprising acid infusion, membrane lung, and a continuous renal replacement therapy console for efficient CO removal at a low blood flow. To evaluate the new system, we used an ex vivo experimental model using swine blood. A liter of aliquoted blood adjusted to pH 7.25 and pCO 65 mm Hg was mixed with acid (0, 10, or 20 mL of lactic or hydrochloric acid [1 mol/L]) and was immediately delivered to the system in a single pass. We collected blood samples at each point of the circuit and calculated the amount of CO eliminated by the membrane lung. The new system removed 13.2 ± 0.8, 32.0 ± 2.1, and 51.6 ± 3.7 mL/min of CO (with 0, 10, and 20 mEq/L of lactic acid) and 21.2 ± 1.2, 27.3 ± 0.3, and 42.0 ± 1.3 mL/min (with 0, 10, and 20 mEq/L of hydrochloric acid), respectively. The levels of lactate and Cl ions for acid-base equilibrium were restored after continuous hemodiafiltration. Thus, the amount of CO eliminated by the membrane lung was 3.9 times higher with lactic acid and 2.0 times higher with hydrochloric acid compared with non-acid controls. In conclusion, this easy-to-setup CO removal system was safe, effective, and removed CO at a low blood flow.
我们开发了一种新型系统，该系统由酸注入装置、膜肺和连续性肾脏替代治疗控制台组成，用于在低血流量情况下高效去除二氧化碳（CO）。为了评估这个新系统，我们使用了猪血液的体外实验模型。将一升调整至pH 7.25和pCO₂ 65 mmHg的等分血液与酸（0、10或20 mL乳酸或盐酸[1 mol/L]）混合，并立即单次通过输送至该系统。我们在回路的每个点采集血样，并计算膜肺去除的CO量。新系统分别以每分钟13.2 ± 0.8、32.0 ± 2.1和51.6 ± 3.7 mL的速度去除CO（分别使用0、10和20 mEq/L的乳酸），以及以每分钟21.2 ± 1.2、27.3 ± 0.3和42.0 ± 1.3 mL的速度（分别使用0、10和20 mEq/L的盐酸）。在连续血液透析滤过后，酸碱平衡的乳酸和氯离子水平得以恢复。因此，与无酸对照组相比，使用乳酸时膜肺去除的CO量高3.9倍，使用盐酸时高2.0倍。总之，这个易于设置的CO去除系统安全、有效，并且能在低血流量情况下去除CO。
