Kolobow T, Spragg R G, Pierce J E
Int J Artif Organs. 1981 Mar;4(2):76-81.
We provided total cardiopulmonary support for 1-18 hours in unanesthetized tethered lambs by peripheral vascular cannulation, using a roller pump and the spiral membrane lung. Respirations were allowed to remain spontaneous and unaided. A Swan-Ganz catheter was placed for retrograde pulmonary artery blood flow sampling. Within a few minutes following induced ventricular fibrillation the PCO2 of sampled blood flowing retrograde through the lungs fell below 10 mm Hg, the PO2 rose to near 150 mm Hg, the pH rose to above 7.8, and the glucose level fell to less than 20 mg %. All of these values later gradually shifted, approaching mixed venous blood values within minutes. After 1-18 hrs of perfusion the animals went into shock and were sacrificed. At autopsy, the lungs of animals breathing room air were beefy and hemorrhagic. In lambs that were "breathing" CO2 enriched air the retrograde pulmonary artery blood pH and PCO2 was usually maintained close to the mixed venous blood values. The observed pulmonary changes were considerably less abnormal, and the microscopic abnormalities were at times nonexistent. We believe the integrity of pulmonary blood flow is vital to the survival of the lungs as a functioning organ. Cessation of total forward pulmonary blood flow (unlike partial cardiopulmonary bypass), combined with spontaneous pulmonary ventilation, rapidly leads to massive, pulmonary infarctions, shock, and death.
我们通过外周血管插管，使用滚压泵和螺旋膜肺，在未麻醉的束缚羔羊中提供了1 - 18小时的全心肺支持。呼吸保持自主且无需辅助。放置了一根 Swan - Ganz 导管用于逆行肺动脉血流采样。在诱发心室颤动后的几分钟内，经肺逆行流动的采样血液的 PCO₂ 降至10 mmHg 以下，PO₂ 升至近150 mmHg，pH 升至7.8以上，血糖水平降至低于20 mg%。所有这些值随后逐渐变化，几分钟内接近混合静脉血的值。灌注1 - 18小时后，动物进入休克状态并被处死。尸检时，呼吸室内空气的动物的肺呈肉质且出血。在“呼吸”富含二氧化碳空气的羔羊中，逆行肺动脉血的 pH 和 PCO₂ 通常保持接近混合静脉血的值。观察到的肺部变化异常程度明显较小，有时微观异常不存在。我们认为肺血流的完整性对于肺作为一个功能器官的存活至关重要。完全停止正向肺血流（与部分体外循环不同），再加上自主肺通气，会迅速导致大面积肺梗死、休克和死亡。
