Edinger Fabian, Zajonz Thomas, Mayer Nico, Schmidt Götz, Schneck Emmanuel, Sander Michael, Koch Christian
Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital, Justus-Liebig-University, 35392 Giessen, Germany.
Biomedicines. 2024 Aug 10;12(8):1819. doi: 10.3390/biomedicines12081819.
The application of venovenous (VV) extracorporeal membrane oxygenation (ECMO) has gained wide acceptance for the treatment of acute severe respiratory failure. Since no rat model of VV ECMO therapy with femoral drainage has yet been described, although this cannulation strategy is commonly used in humans, this study aimed to establish such a model. Twenty male Lewis rats were randomly assigned to receive a sham procedure or VV ECMO therapy. After the inhalative induction of anesthesia, animals were intubated and the vascular accesses were placed surgically. While venous drainage was achieved through a modified multi-orifice 18 G cannula that was placed in the inferior vena cava through the femoral vein over a guide wire with an ultra-flexible tip, the venous return was realized via a shortened 20 G cannula into the jugular vein. Hemodynamic data were obtained from a tail artery and left ventricular pressure-volume catheter. Repetitive blood gas analyses were carried out, and systemic inflammation was measured using an enzyme-linked immunosorbent assay. While animals in the ECMO group showed adequate oxygenation and decarboxylation, there was no evidence of recirculation. VV ECMO therapy increased stroke volume (SV), cardiac output (CO), and left ventricular end-diastolic volume (LVEDV). ECMO-induced inflammation was reflected in increased levels of tumor necrosis factor alpha. However, no differences in interleukins 6 and 10 were seen. This study describes a frequently used cannulation strategy in humans for a rat model of VV ECMO. Despite successful oxygenation and decarboxylation, the oxygenated blood may reduce pulmonary vascular resistance and lead to an increased LVEDV, which is associated with increased SV and CO. This model allows us to answer research questions about topics such as intestinal microcirculation in further studies.
静脉-静脉（VV）体外膜肺氧合（ECMO）在急性严重呼吸衰竭治疗中的应用已得到广泛认可。尽管这种插管策略在人类中常用，但目前尚未有关于采用股静脉引流的VV ECMO治疗大鼠模型的描述，因此本研究旨在建立这样一种模型。将20只雄性Lewis大鼠随机分为两组，分别接受假手术或VV ECMO治疗。经吸入诱导麻醉后，对动物进行气管插管，并通过手术建立血管通路。静脉引流通过一根改良的多孔18G插管实现，该插管经股静脉在超柔性尖端导丝引导下置入下腔静脉；静脉回血则通过一根缩短的20G插管经颈静脉实现。从尾动脉和左心室压力-容积导管获取血流动力学数据。进行重复血气分析，并采用酶联免疫吸附测定法测量全身炎症反应。ECMO组动物显示出充分的氧合和二氧化碳清除，且无再循环迹象。VV ECMO治疗增加了每搏输出量（SV）、心输出量（CO）和左心室舒张末期容积（LVEDV）。ECMO诱导的炎症反应表现为肿瘤坏死因子α水平升高。然而，白细胞介素6和10水平未见差异。本研究描述了一种在人类中常用的插管策略用于VV ECMO大鼠模型。尽管氧合和二氧化碳清除成功，但氧合血可能会降低肺血管阻力并导致LVEDV增加，这与SV和CO增加相关。该模型使我们能够在进一步研究中回答有关肠道微循环等主题的研究问题。
