Togo Konomi, Takewa Yoshiaki, Katagiri Nobumasa, Fujii Yutaka, Yamashita Akihiro C, Tastumi Eisuke
1 Department of Medical Course, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan.
2 Department of Artificial Organs, National Cerebral and Cardiovascular Center, Osaka, Japan.
Int J Artif Organs. 2018 Dec;41(12):867-871. doi: 10.1177/0391398818795357. Epub 2018 Sep 17.
: Recently, the use of veno-venous extracorporeal membrane oxygenation for adult patients with severe acute respiratory failure has increased. We previously investigated the optimal return cannula position; however, the optimal drainage cannula position has not yet been fully clarified. The aim of this study was to investigate the optimal drainage cannula position.
: Veno-venous extracorporeal membrane oxygenation was performed in four adult goats (mean body weight 59.6 ± 0.6 kg). The position of the drainage cannula was varied among the right atrium, the upper inferior vena cava, and the lower inferior vena cava, whereas the position of the return cannula was fixed in the superior vena cava. The recirculation fraction and arterial oxygen saturation and pressure (SaO, PaO) were measured in all drainage cannula positions.
: In the lower inferior vena cava drainage cannula position, the recirculation fraction was the lowest. In the lower inferior vena cava, upper inferior vena cava, and right atrium drainage cannula positions at 3 L/min, SaO and PaO after 20 min were 92.9% ± 4.9% and 75.1 ± 26.0 mm Hg, 99.5% ± 0.5% and 113.8 ± 20.9 mm Hg, and 93.8% ± 6.2% and 91.9 ± 17.7 mm Hg, respectively.
: With respect to blood oxygenation, the optimal position for the drainage cannula was the upper inferior vena cava. These findings suggested that blood from the superior vena cava, inferior vena cava, and hepatic vein was most efficiently drained in the upper inferior vena cava cannula position.
最近，静脉 - 静脉体外膜肺氧合在患有严重急性呼吸衰竭的成年患者中的应用有所增加。我们之前研究了最佳回血插管位置；然而，最佳引流插管位置尚未完全明确。本研究的目的是探究最佳引流插管位置。
对四只成年山羊（平均体重59.6 ± 0.6千克）进行静脉 - 静脉体外膜肺氧合。引流插管的位置在右心房、上腔静脉和下腔静脉之间变化，而回血插管的位置固定在上腔静脉。在所有引流插管位置测量再循环分数以及动脉血氧饱和度和压力（SaO、PaO）。
在下腔静脉引流插管位置，再循环分数最低。在流量为3升/分钟时，下腔静脉、上腔静脉和右心房引流插管位置在20分钟后的SaO和PaO分别为92.9% ± 4.9%和75.1 ± 26.0毫米汞柱、99.5% ± 0.5%和113.8 ± 20.9毫米汞柱、93.8% ± 6.2%和91.9 ± 17.7毫米汞柱。
就血液氧合而言，引流插管的最佳位置是上腔静脉。这些发现表明，在上腔静脉插管位置，来自上腔静脉、下腔静脉和肝静脉的血液能最有效地引流。
