Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
88th Surgical Operations Squadron, Wright-Patterson Medical Center, WPAFB, Dayton, Ohio, USA.
Artif Organs. 2023 Nov;47(11):1794-1797. doi: 10.1111/aor.14623. Epub 2023 Aug 17.
Ex vivo lung perfusion (EVLP) enables lung resuscitation before transplantation, and training is key, particularly in low-volume settings. To enable technique refinement and continuing education, we sought to demonstrate the value of a low-cost, high-fidelity EVLP simulator that would allow reproducible clinical scenarios.
In partnership with our EVLP manufacturer, we utilized the XPS™ Jensen Lung with our clinical system. The Jensen Lung has two simulated lung bladders and an in-line polymethylpentene fiber oxygenator. It allows titration of ventilator support which aids in accurate clinical simulation. For simulations, blood gases (BGs) were obtained and compared with integrated in-line perfusate gas monitors (PGMs). PaO , PCO , and pH were measured and compared.
The PGM and BG values were not significantly different throughout the range of FiO and sweep gas flow rates evaluated. The "delta" PaO was measured between LA and PA and did not show any change between approaches. The pH measurement between BG and PGM was not significantly different.
The XPS™ Jensen Lung simulator allows for a high-fidelity simulator of clinical EVLP. The correlation of the PGM and the BG measurement of the PaO and pH allow for a low-cost simulation, as the PGMs are in line in the circuit, and enable real-time tracking of perfusate gas parameters with the PGM. Implementation of a standardized clinical EVLP training program allows the maintenance of technique and enables clinical simulation training without the need for costly animal perfusions and the use of multiple BG measurements.
体外肺灌注 (EVLP) 可在移植前进行肺复苏,培训是关键,尤其是在低容量环境下。为了实现技术改进和继续教育,我们寻求展示一种低成本、高保真度的 EVLP 模拟器的价值,该模拟器将允许重现临床场景。
我们与 EVLP 制造商合作,使用我们的临床系统中的 XPS™ Jensen 肺。Jensen 肺有两个模拟肺囊和一个在线聚甲基戊烯纤维氧合器。它允许滴定呼吸机支持,从而有助于准确的临床模拟。在模拟过程中,获得血气 (BG) 并与集成在线灌流气体监测器 (PGM) 进行比较。测量并比较 PaO、PCO 和 pH。
在评估的 FiO 和扫气气流速率范围内,PGM 和 BG 值没有显着差异。在 LA 和 PA 之间测量“delta”PaO,并且在两种方法之间没有显示任何变化。BG 和 PGM 之间的 pH 测量没有显着差异。
XPS™ Jensen 肺模拟器可实现临床 EVLP 的高保真模拟器。PGM 和 BG 测量的 PaO 和 pH 的相关性允许进行低成本模拟,因为 PGM 在线路中,并且能够实时跟踪 PGM 中的灌流气体参数。实施标准化的临床 EVLP 培训计划允许维持技术,并能够进行临床模拟培训,而无需昂贵的动物灌注和多次 BG 测量。