Fujii Tasuku, Yoneyama Yosuke, Kinebuchi Akiko, Ozeki Naoki, Maeda Sho, Saiki Norikazu, Chen-Yoshikawa Toyofumi Fengshi, Date Hiroshi, Nishiwaki Kimitoshi, Takebe Takanori
Department of Anesthesiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Institute of Research, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan.
iScience. 2023 Feb 13;26(3):106142. doi: 10.1016/j.isci.2023.106142. eCollection 2023 Mar 17.
The potential of extrapulmonary ventilation pathways remains largely unexplored. Here, we assessed the enteral ventilation approach in hypoxic porcine models under controlled mechanical ventilation. 20 mL/kg of oxygenated perfluorodecalin (O-PFD) was intra-anally delivered by a rectal tube. We simultaneously monitored arterial and pulmonary arterial blood gases every 2 min up to 30 min to determine the gut-mediated systemic and venous oxygenation kinetics. Intrarectal O-PFD administration significantly increased the partial pressure of oxygen in arterial blood from 54.5 ± 6.4 to 61.1 ± 6.2 mmHg (mean ± SD) and reduced the partial pressure of carbon dioxide from 38.0 ± 5.6 to 34.4 ± 5.9 mmHg. Early oxygen transfer dynamics inversely correlate with baseline oxygenation status. SvO dynamic monitoring data indicated that oxygenation likely originated from the venous outflow of the broad segment of large intestine including the inferior mesenteric vein route. Enteral ventilation pathway offers an effective means for systemic oxygenation, thus warranting further clinical development.
肺外通气途径的潜力在很大程度上仍未得到探索。在此，我们在控制性机械通气下评估了低氧猪模型中的肠内通气方法。通过直肠管经肛门给予20 mL/kg的氧合全氟萘烷（O-PFD）。我们每2分钟同时监测动脉和肺动脉血气，持续30分钟，以确定肠道介导的全身和静脉氧合动力学。经直肠给予O-PFD显著提高了动脉血中的氧分压，从54.5±6.4 mmHg升至61.1±6.2 mmHg（平均值±标准差），并降低了二氧化碳分压，从38.0±5.6 mmHg降至34.4±5.9 mmHg。早期氧转运动力学与基线氧合状态呈负相关。SvO动态监测数据表明，氧合可能源于包括肠系膜下静脉途径在内的大肠宽段的静脉流出。肠内通气途径为全身氧合提供了一种有效手段，因此值得进一步进行临床开发。
