Albes J M, Brandes H, Heinemann M K, Scheule A, Wahlers T
Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Germany.
Eur Surg Res. 1997;29(5):327-38. doi: 10.1159/000129540.
In recent years several potassium-reduced solutions have been developed for improvement of pulmonary preservation. A comparison of these solutions in a single study, however, has not yet been performed. In an extracorporeal working rat heart-lung model (n = 7/group) lungs were preserved with 20 ml Euro-Collins (EC), low potassium EC (LPEC), low potassium 2% dextran (LPD), ET-Kyoto (ETK) or low potassium 5% dextran (Perfadex) solution, while hearts were arrested with 10 ml St. Thomas' cardioplegia. Lungs of controls were not perfused. The heart-lung blocks were stored for 2 h at 10 degrees C. Thereafter, heart-lung blocks were extracorporeally perfused with Krebs-Henseleit solution with washed bovine red blood cells. Coronaries were perfused with oxygenated perfusate. Lungs were perfused via the working right ventricle with deoxygenated perfusate and ventilated with room air. Oxygenation capacity (dPO2) and pulmonary vascular resistance (PVR) were measured. Reperfusion/ventilation was performed for 40 min. At the end of the experiment the wet to dry (W/D) ratio of lungs and light microscopic assessment of the degree of edema (0-4) were performed. All potassium-reduced solutions showed superior dPO2 and a lower PVR than EC and controls while LPEC exhibited the most stable dPO2 and lowest PVR after 30 min reperfusion. The W/D ratio of all potassium-reduced groups was lower than the ratio of EC and controls. In LPEC, ETK and Perfadex the least degree of edema was noted. All solutions used in this study are superior to regular EC. However, when compared directly, LPEC perfused lungs showed better functional preservation than all other alternative solutions.
近年来，已研发出几种低钾溶液用于改善肺保存。然而，尚未在一项单一研究中对这些溶液进行比较。在一个体外工作的大鼠心肺模型（每组n = 7）中，用20毫升欧洲柯林斯（EC）溶液、低钾EC（LPEC）溶液、低钾2%右旋糖酐（LPD）溶液、ET - 京都（ETK）溶液或低钾5%右旋糖酐（Perfadex）溶液保存肺，同时用10毫升圣托马斯心脏停搏液使心脏停搏。对照组的肺未灌注。心肺块在10℃下保存2小时。此后，用心肺块用含有洗涤过的牛红细胞的克雷布斯 - 亨泽莱特溶液进行体外灌注。冠状动脉用含氧灌注液灌注。肺通过工作的右心室用脱氧灌注液灌注并用室内空气通气。测量氧合能力（dPO₂）和肺血管阻力（PVR）。进行再灌注/通气40分钟。在实验结束时，测量肺的湿重与干重（W/D）比，并进行光镜下水肿程度（0 - 4级）评估。所有低钾溶液的dPO₂均优于EC溶液和对照组，且PVR更低，而LPEC在再灌注30分钟后表现出最稳定的dPO₂和最低的PVR。所有低钾组的W/D比均低于EC组和对照组。在LPEC、ETK和Perfadex组中，水肿程度最轻。本研究中使用的所有溶液均优于常规EC溶液。然而，直接比较时，灌注LPEC溶液的肺比所有其他替代溶液显示出更好的功能保存。
