Albes J M, Fischer F, Bando T, Heinemann M K, Scheule A, Wahlers T
Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Germany.
Eur Surg Res. 1997;29(1):5-11. doi: 10.1159/000129501.
The optimal temperature of the pulmonary flush perfusate is still a matter of controversy. At present, a temperature of 10 degrees C is favored. This study deals with the structural and functional impact of different perfusate temperatures on lung preservation. In an extracorporeal rat heart-lung model lungs were preserved with Perfadex solution of 4, 15 and 25 degrees C and submitted to 2 h ischemia. Heart-lung blocks harvested from male rats were perfused with Krebs-Henseleit solution and ventilated with room air. Lungs were perfused with deoxygenated perfusate via the working right ventricle while the coronary arteries were retrogradely perfused with oxygenated perfusate. Oxygenation capacity (dPO2), peak inspiratory pressure (PIP) and pulmonary vascular resistance were measured. After establishment of baseline functional parameters hearts were arrested with 10 ml St. Thomas cardioplegia and lungs were flushed with 20 ml Perfadex solution. The heart-lung block was then stored for 2 h at 10 degrees C. Reperfusion was performed thereafter under the same conditions. At the end of the trial the lung tissue water was measured by the wet/dry ratio. The perfusion time of the groups flushed with 15 or 25 degrees C perfusate was significantly lower than that of the 4 degrees C group. After 20 min reperfusion dPO2 of the groups flushed with 15 or 25 degrees C was superior to those submitted to a 4 degrees C flush perfusion. PIP was significantly lower in the 15 degrees C group than in the 4 and 25 degrees C groups. The wet/dry ratio revealed the smallest water content in the 15 degrees C group. We conclude that the post-ischemic lung function is dependent on the temperature of the flush perfusate. Among the tested temperatures, perfusion at 15 degrees C showed the best results. The optimum may therefore lie in this range.
肺灌洗灌注液的最佳温度仍存在争议。目前，10摄氏度的温度更受青睐。本研究探讨了不同灌注液温度对肺保存的结构和功能影响。在体外大鼠心肺模型中，用4、15和25摄氏度的Perfadex溶液保存肺，并进行2小时的缺血处理。从雄性大鼠获取的心肺块用Krebs-Henseleit溶液灌注，并用室内空气通气。通过工作的右心室用脱氧灌注液灌注肺，同时通过冠状动脉逆行用氧合灌注液灌注。测量氧合能力（dPO2）、吸气峰压（PIP）和肺血管阻力。在建立基线功能参数后，用10毫升圣托马斯心脏停搏液使心脏停搏，并用20毫升Perfadex溶液冲洗肺。然后将心肺块在10摄氏度下保存2小时。此后在相同条件下进行再灌注。在试验结束时，通过湿/干比测量肺组织含水量。用15或25摄氏度灌注液冲洗的组的灌注时间明显低于4摄氏度组。再灌注20分钟后，用15或25摄氏度冲洗的组的dPO2优于接受4摄氏度冲洗灌注的组。15摄氏度组的PIP明显低于4和25摄氏度组。湿/干比显示15摄氏度组的含水量最小。我们得出结论，缺血后肺功能取决于灌洗灌注液的温度。在测试的温度中，15摄氏度灌注显示出最佳结果。因此，最佳温度可能在这个范围内。
