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微孔膜式氧合器的呼吸特性

Respiratory characteristics of a microporous membrane oxygenator.

作者信息

Karlson K E, Massimino R J, Cooper G N, Singh A K, Vargas L L

出版信息

Ann Surg. 1977 Apr;185(4):397-401. doi: 10.1097/00000658-197704000-00004.

Abstract

A microporous membrane oxygenator has been used in 258 clinical perfusions for cardiac surgery. In 132 perfusions the oxygenator was ventilated with 100% O2, and in 126 perfusions 98% O2-2%CO2 was used. Patients' BSA was 0.4-2.3 M2. Bypass duration was up to 563 min. In the group ventilated with 100% O2, average PaCO2 was 30 mmHg, with arterial pH of 7.48. 98% O2-2% ventilation resulted in an average PaCO2 of 36 mmHg, with arterial pH of 7.41. CO2 transfer is influenced by gas flow rate, and data from selected cases demonstrate that increasing gas flow results in decreasing PaCO2, while decreasing gas flow increases PaCO2. The thickness of the blood film is decreased by increasing the "shim" pressure, so that increasing the "shim" presure results in higher PaO2. Oxygen saturation averaged 99% for the entire series. Addition of CO2 to the oxygen and appropriate changes in gas flow and "shim" pressure permit changes to be made in the ventilation of the device during perfusion to achieve desired levels of PaO2 and PaCO2 under widely disparate conditions of temperature and flow.

摘要

一种微孔膜氧合器已用于258例心脏手术的临床灌注。在132例灌注中,氧合器用100%氧气通气,在126例灌注中使用98%氧气-2%二氧化碳。患者的体表面积为0.4-2.3平方米。体外循环时间长达563分钟。在使用100%氧气通气的组中,平均动脉血二氧化碳分压为30 mmHg,动脉血pH值为7.48。98%氧气-2%二氧化碳通气导致平均动脉血二氧化碳分压为36 mmHg,动脉血pH值为7.41。二氧化碳的传输受气体流速影响,所选病例的数据表明,增加气体流速会导致动脉血二氧化碳分压降低,而降低气体流速会使动脉血二氧化碳分压升高。通过增加“垫片”压力可使血膜厚度减小,从而增加“垫片”压力会使动脉血氧分压升高。整个系列的氧饱和度平均为99%。在氧气中添加二氧化碳以及适当改变气体流速和“垫片”压力,可在灌注过程中对该装置的通气进行调整,以便在温度和流速差异很大的条件下达到所需的动脉血氧分压和动脉血二氧化碳分压水平。

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Respiratory characteristics of a microporous membrane oxygenator.微孔膜式氧合器的呼吸特性
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