Wisser W, Ringl H, Wekerle T, Wolner E, Klepetko W
Department of Cardiothoracic Surgery, University of Vienna, Austria.
J Heart Lung Transplant. 1995 Mar-Apr;14(2):289-95.
The aim of this study was to compare the effect of the most frequently used clinical preservation solution (Euro-Collins, group I) with a newly composed low potassium, glucose- and insulin-containing preservation solution (141 mmol/L sodium, 6.4 mmol/L potassium, 119 mmol/L chloride, 5 mmol/L magnesium, 10 gm/L glucose, 10 gm/L dextrane and 20 U/L insulin) (group II) on postischemic lung function.
We studied 12 isolated New Zealand White rabbit lungs in a closed circuit model during the first 4 hours of reperfusion after 24 hours of ischemic hypothermic storage.
Oxygenation capacity, defined by the difference between the arterial and venous oxygen tension was significantly higher in group II compared with group I after 10 (58.7 +/- 5.8 versus 34.9 +/- 7.5 mm Hg), 30 (63.5 +/- 7.8 versus 27.3 +/- 10.4 mm Hg) and 180 minutes (77.7 +/- 7.2 versus 8.8 +/- 5.6 mm Hg). Ventilatory pressure was significantly lower in group II after 1 minute (11.3 +/- 1.3 mm Hg versus 13.7 +/- 0.5 mm Hg, p < 0.05), with no significant difference thereafter. No significant difference was found in pulmonary vascular resistance except after 20 minutes (30.8 +/- 1.2 dyns/cm5 [group I] versus 27.1 +/- 1.1 dyns/cm5 [group II], p < 0.05).
These data suggest that this new solution provides superior lung function after 24 hours ischemic time compared with Euro-Collins solution.
本研究旨在比较最常用的临床保存液（欧林柯林斯液，I组）与新配制的含低钾、葡萄糖和胰岛素的保存液（141 mmol/L钠、6.4 mmol/L钾、119 mmol/L氯、5 mmol/L镁、10 g/L葡萄糖、10 g/L右旋糖酐和20 U/L胰岛素）（II组）对缺血后肺功能的影响。
我们在12只新西兰白兔离体肺的封闭回路模型中，研究了24小时低温缺血保存后再灌注的最初4小时。
在再灌注10分钟（58.7±5.8对34.9±7.5 mmHg）、30分钟（63.5±7.8对27.3±10.4 mmHg）和180分钟（77.7±7.2对8.8±5.6 mmHg）后，II组由动脉血氧分压与静脉血氧分压差值定义的氧合能力显著高于I组。II组在1分钟后的通气压力显著较低（11.3±1.3 mmHg对13.7±0.5 mmHg，p<0.05），此后无显著差异。除20分钟后（I组30.8±1.2 dyns/cm5对II组27.1±1.1 dyns/cm5，p<0.05）外，肺血管阻力无显著差异。
这些数据表明，与欧林柯林斯液相比，这种新溶液在缺血24小时后能提供更好的肺功能。
