Sasaki M, Muraoka R, Chiba Y, Hiramatu Y
Second Department of Surgery, Fukui Medical School, Japan.
Transplantation. 1996 Jan 15;61(1):22-7. doi: 10.1097/00007890-199601150-00006.
The effect of changing pulmonary artery pressure during flushing (flushing pressure) on lung preservation was examined in an ex vivo rabbit lung perfusion model. Both lungs were flushed in situ with 200 ml of a preservation solution (extracellular fluid [ECF] type) at 8 degrees C, at a constant flushing pressure maintained by regulating the flushing flow rate from 20 to 120 ml/min. In the controls, the flushing pressure was maintained at 15 mmHg and the lungs were assessed without storage. In the other 5 groups (n = 7 in each group), the lungs were flushed at pressures of 5, 10, 15, 20, and 25 mmHg, respectively. The heart-lung block was then harvested, and immersed in the same solution at 8 degrees C for 24 hr. After 24 hr of storage, the block was reperfused with pooled venous blood for 10 min, and then with oxygenated blood for another 60 min in a closed circuit. Assessment of lung function included blood gas analysis of effluent blood, pulmonary artery pressure, airway pressure, wet:dry weight ratio, and histologic study. At flushing pressures of 5, 20, and 25 mmHg, uniform and clear flushing out of the pulmonary vascular beds was not obtained, resulting in postperfusion pulmonary hypofunction and a high incidence of pulmonary edema. However, at flushing pressures of 10-15 mmHg, we succeeded in completely flushing out the pulmonary vascular beds, and managed to preserve good pulmonary function. In conclusion, we determined the optimal flushing pressure for rabbit lung preservation to be 10-15 mmHg.
在离体兔肺灌注模型中，研究了冲洗过程中肺动脉压力变化（冲洗压力）对肺保存的影响。在8℃下，用200ml保存液（细胞外液[ECF]型）原位冲洗双肺，通过调节冲洗流速从20至120ml/min维持恒定的冲洗压力。对照组中，冲洗压力维持在15mmHg，且不进行储存直接评估肺。在其他5组（每组n = 7）中，肺分别在5、10、15、20和25mmHg的压力下冲洗。然后切取心肺块，浸入8℃的相同溶液中24小时。储存24小时后，在封闭回路中用混合静脉血对心肺块再灌注10分钟，然后用含氧血再灌注60分钟。肺功能评估包括流出血液的血气分析、肺动脉压力、气道压力、湿重与干重比以及组织学研究。在5、20和25mmHg的冲洗压力下，未获得肺血管床均匀且清晰的冲洗效果，导致灌注后肺功能减退和肺水肿的高发生率。然而，在10 - 15mmHg的冲洗压力下，我们成功完全冲洗出肺血管床，并成功保存了良好的肺功能。总之，我们确定兔肺保存的最佳冲洗压力为10 - 15mmHg。
