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体外循环后的红细胞存活。膜式与鼓泡式氧合器的问题。

Erythrocyte survival following extracorporeal circulation. A question of membrane versus bubble oxygenator.

作者信息

Tabak C, Eugene J, Stemmer E A

出版信息

J Thorac Cardiovasc Surg. 1981 Jan;81(1):30-3.

PMID:7453219
Abstract

Five groups of seven dogs were studied. Each animal had 250 ml of blood withdrawn and tagged with Cr51. Group I (control) samples were combined with 500 ml of lactated Ringer's solution and reinfused into the respective animals after 3 hours of incubation at 37 degrees C. Group II samples were pumped in a closed-circuit bubble oxygenator with 500 ml of lactated Ringer's prime for 2 hours before reinfusion into the animals. Group III samples were pumped in a bubble oxygenator for 3 hours before reinfusion. Group IV samples were pumped in a closed-circuit membrane oxygenator for 2 hours, and Group V samples were pumped in a membrane circuit for 3 hours. All extracorporeal pump runs were performed at 37 degrees C. Blood samples were drawn from the dogs at regular intervals after bypass for 30 days. Erythrocyte survival was determined by Cr51 activity recorded by a gamma counter. The red cell half-life was determined for each dog. The control half-life was 24.1 +/- 2.03 days; Group II, 19.88 +/- 1.69 (p < 0.05); Group III, 9.63 +/- 1.4 (p < 0.001); Group IV, 19.4 +/- 1.65 (p < 0.05); and Group V, 9.13 +/- 1.45 (p < 0.001). These data indicate that serious red cell injury does occur with extracorporeal circulation but that the injury is a function of pump time, rather than of the type of oxygenator.

摘要

对五组,每组七只狗进行了研究。每只动物抽取250毫升血液并用铬51标记。第一组(对照组)样本与500毫升乳酸林格氏液混合,在37℃孵育3小时后回输到相应动物体内。第二组样本在闭路鼓泡式氧合器中与500毫升乳酸林格氏预充液一起泵注2小时,然后回输到动物体内。第三组样本在鼓泡式氧合器中泵注3小时后回输。第四组样本在闭路膜式氧合器中泵注2小时,第五组样本在膜式回路中泵注3小时。所有体外循环泵运行均在37℃进行。在体外循环后30天内定期从狗身上采集血样。通过γ计数器记录的铬51活性测定红细胞存活率。测定每只狗的红细胞半衰期。对照组半衰期为24.1±2.03天;第二组为19.88±1.69(p<0.05);第三组为9.63±1.4(p<0.001);第四组为19.4±1.65(p<0.05);第五组为9.13±1.45(p<0.001)。这些数据表明,体外循环确实会导致严重的红细胞损伤,但这种损伤是泵注时间的函数,而不是氧合器类型的函数。

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