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腹腔内氧微泡疗法:一种在急性缺氧性呼吸衰竭烟雾吸入模型中增强全身氧合的新方法。

Intraperitoneal oxygen microbubble therapy: A novel approach to enhance systemic oxygenation in a smoke inhalation model of acute hypoxic respiratory failure.

作者信息

Leiphrakpam Premila D, Weber Hannah R, Foster Kirk W, Buesing Keely L

机构信息

University of Nebraska Medical Center College of Medicine, Department of Surgery, Omaha, NE, USA.

University of Nebraska Medical Center College of Medicine, Department of Pathology and Microbiology, Omaha, NE, USA.

出版信息

Surg Open Sci. 2023 Oct 11;16:127-133. doi: 10.1016/j.sopen.2023.09.020. eCollection 2023 Dec.

Abstract

BACKGROUND

Patients suffering from severe acute respiratory distress syndrome (ARDS) face limited therapeutic options and alarmingly high mortality rates. Refractory hypoxemia, a hallmark of ARDS, often necessitates invasive and high-risk treatments. Oxygen microbubbles (OMB) present a promising approach for extrapulmonary oxygenation, potentially augmenting systemic oxygen levels without exposing patients to significant risks.

METHODS

Rats with severe, acute hypoxemia secondary to wood smoke inhalation (SI) received intraperitoneal (IP) bolus injections of escalating weight-by-volume (BW/V) OMB doses or normal saline to determine optimal dosage and treatment efficacy. Subsequently, a 10 % BW/V OMB bolus or saline was administered to a group of SI rats and a control group of healthy rats (SHAM). Imaging, vital signs, and laboratory studies were compared at baseline, post-smoke inhalation, and post-treatment. Histological examination and lung tissue wet/dry weight ratios were assessed at study conclusion.

RESULTS

Treatment with various OMB doses in SI-induced acute hypoxemia revealed that a 10 % BW/V OMB dose significantly augmented systemic oxygen levels while minimizing dose volume. The second set of studies demonstrated a significant increase in partial pressure of arterial oxygen (PaO2) and normalization of heart rate with OMB treatment in the SI group compared to saline treatment or control group treatment.

CONCLUSIONS

This study highlights the successful augmentation of systemic oxygenation following OMB treatment in a small animal model of severe hypoxemia. OMB therapy emerges as a novel and promising treatment modality with immense translational potential for oxygenation support in acute care settings.

摘要

背景

患有严重急性呼吸窘迫综合征(ARDS)的患者面临有限的治疗选择以及高得惊人的死亡率。难治性低氧血症是ARDS的一个标志,常常需要进行侵入性的高风险治疗。氧微泡(OMB)为肺外氧合提供了一种有前景的方法,有可能在不使患者面临重大风险的情况下提高全身氧水平。

方法

吸入木烟(SI)继发严重急性低氧血症的大鼠接受腹腔内(IP)推注递增体积比体重(BW/V)的OMB剂量或生理盐水,以确定最佳剂量和治疗效果。随后,对一组SI大鼠和一组健康大鼠(假手术组)给予10% BW/V的OMB推注或生理盐水。在基线、吸入烟雾后和治疗后比较成像、生命体征和实验室检查结果。在研究结束时评估组织学检查和肺组织湿/干重比。

结果

在SI诱导的急性低氧血症中用不同剂量的OMB进行治疗发现,10% BW/V的OMB剂量在使剂量体积最小化的同时显著提高了全身氧水平。第二组研究表明,与生理盐水治疗或对照组治疗相比,SI组接受OMB治疗后动脉血氧分压(PaO2)显著升高,心率恢复正常。

结论

本研究突出了在严重低氧血症的小动物模型中OMB治疗后全身氧合的成功增强。OMB疗法成为一种新颖且有前景的治疗方式,在急性护理环境中具有巨大的氧合支持转化潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15e2/10594636/ed7c91668619/gr1.jpg

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