Kitamura M, Shibuya M, Kurihara H, Akimoto T, Endo M, Koyanagi H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
Artif Organs. 1997 Jul;21(7):786-8. doi: 10.1111/j.1525-1594.1997.tb03743.x.
We examined a new technique of cross-circulation (CC) venoarterial bypass (VAB) with femoral arterial perfusion and superior vena cava drainage through a long femoral venous cannula. Six adult mongrel dogs weighing 15 to 20 kg underwent the CC-VAB with oxygenation after introduction of respiratory failure (RF). The flow of the CC-VAB was maintained at half the level of the control cardiac output, and the hemodynamic parameters were monitored. To evaluate hypoxia in the upper body, the arterial partial pressure of oxygen (PaO2 [mm Hg]) in the carotid artery and the venous saturation of oxygen (SvO2 [%]) in the pulmonary artery were measured during control, RF, standard VAB, and CC-VAB conditions. The PaO2 decreased significantly after the introduction of RF (41.7 +/- 12.4), and it returned to normal levels only after CC-VAB (151.2 +/- 24.5, p < 0.05). The SvO2 during CC-VAB (98.6 +/- 2.1) was significantly higher than that during VAB without CC (53.5 +/- 3.4, p < 0.05). These results suggest that this cross-circulation technique could be applied to patients with differential hypoxia during femoral VAB with oxygenation or percutaneous cardiopulmonary support (PCPS).
我们研究了一种新的交叉循环（CC）静脉-动脉旁路（VAB）技术，该技术通过一根长股静脉插管进行股动脉灌注和上腔静脉引流。六只体重15至20千克的成年杂种犬在出现呼吸衰竭（RF）后接受了带氧合的CC-VAB。CC-VAB的血流量维持在对照心输出量水平的一半，并监测血流动力学参数。为了评估上半身的缺氧情况，在对照、RF、标准VAB和CC-VAB条件下，测量颈动脉的动脉血氧分压（PaO2 [mmHg]）和肺动脉的静脉血氧饱和度（SvO2 [%]）。引入RF后，PaO2显著下降（41.7 +/- 12.4），仅在CC-VAB后恢复到正常水平（151.2 +/- 24.5，p < 0.05）。CC-VAB期间的SvO2（98.6 +/- 2.1）显著高于无CC的VAB期间（53.5 +/- 3.4，p < 0.05）。这些结果表明，这种交叉循环技术可应用于在带氧合的股动脉VAB或经皮心肺支持（PCPS）期间出现差异性缺氧的患者。
