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自体氧合体外循环:血流动力学和气体测量参数

Extracorporeal circulation with autogenous oxygenation: hemodynamic and gasometric parameters.

作者信息

Marques E, Oshiro M S, Cestari I A, Hayashida S A, Leirner A A

机构信息

Heart Institute of São Paulo, Medical School, Brazil.

出版信息

Artif Organs. 1995 May;19(5):470-4. doi: 10.1111/j.1525-1594.1995.tb02361.x.

Abstract

Ten experimental perfusions with autogenous oxygenation were performed in mongrel dogs to evaluate the efficacy of the procedure in maintaining normal hemodynamic the efficacy of the procedure in maintaining normal hemodynamic conditions and adequate blood gases for 1 h. Blood was drained from the right and left atria and pumped to the pulmonary artery and aorta, respectively. Two closed circuits containing compliant chambers and roller pumps were utilized. Artificial ventilation with an FiO2 of 50% were used in 5 animals and with an FiO2 level of 30% in the other 5. EKG, cardiac output, aortic, pulmonary artery, and left atrium pressures were registered. Pulmonary tissue was biopsied after perfusion. The heart was electrically fibrillated after perfusion was established and defibrillated at the end of the bypass. The procedure was able to maintain blood gases and pulmonary, aortic, and left atrial pressures within normal ranges during the perfusion. The mobility of the heart and the access to all coronary arteries was excellent. Clinical central nervous system evaluation, EKG tracings, and pulmonary histological exams showed no adverse effects of perfusion. We conclude that the technique employed may present a suitable proceeding for extracorporeal circulation in closed heart surgeries, and its clinical application should be evaluated as a safe and economical alternative.

摘要

在杂种犬身上进行了十次自体氧合实验灌注,以评估该程序在维持正常血流动力学状态以及在1小时内维持正常血气水平方面的效果。血液分别从左右心房引出,再分别泵入肺动脉和主动脉。使用了两个包含顺应性腔室和滚压泵的闭合回路。5只动物采用50%的吸入氧浓度(FiO2)进行人工通气,另外5只采用30%的FiO2水平进行人工通气。记录心电图、心输出量、主动脉、肺动脉和左心房压力。灌注后对肺组织进行活检。在建立灌注后使心脏发生电颤动,并在体外循环结束时进行除颤。该程序能够在灌注期间将血气以及肺动脉、主动脉和左心房压力维持在正常范围内。心脏的活动度以及对所有冠状动脉的显露情况都非常好。临床中枢神经系统评估、心电图描记以及肺组织学检查均未显示灌注有不良影响。我们得出结论,所采用的技术可能是心脏直视手术体外循环的一种合适方法,其临床应用应作为一种安全且经济的替代方案进行评估。

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