Efficiency in Extracorporeal Membrane Oxygenation-Cellular Deposits on Polymethypentene Membranes Increase Resistance to Blood Flow and Reduce Gas Exchange Capacity
Efficiency in Extracorporeal Membrane Oxygenation-Cellular Deposits on Polymethypentene Membranes Increase Resistance to Blood Flow and Reduce Gas Exchange Capacity
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DOI：
10.1097/mat.0b013e318186a807
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发表时间：
2008-11-01
期刊：
影响因子：
4.2
通讯作者：
Schmid, Christof
中科院分区：
文献类型：
--
作者：
Lehle, Karla;Philipp, Alois;Schmid, Christof
生物素涂层聚甲基戊烯（PMP）膜式氧合器（MO）用于体外膜式氧合（ECMO），以改善严重急性呼吸窘迫综合征（ARDS）患者的气体交换。然而，在一些患者中，长期的耐久性是有限的，由于纤维和细胞的气体交换表面上的积累，可以增加血液流动和扩散path. These表面沉积物的PMP MO去除后，扫描电子和荧光显微镜技术进行了研究。在ECMO环境中接受PMP MO支持的31例患者中，有3例患者在平均支持间隔11 +/- 7天后因流动阻力增加和气体交换能力受损而需要更换氧合器。MO的膜表面覆盖有纤维网络，其中嵌入血小板和红细胞。大面积的PMP纤维上覆盖着由单细胞和细胞簇组成的膜状结构。我们假设这些细胞沉积物降低了ECMO的功效。这些细胞的鉴定可能是未来治疗干预和改善MO发展的关键。ASAIO期刊2008; 54：612-617.
Bioline-coated polymethylpentene (PMP) membrane oxygenators (MO) are used for extracorporeal membrane oxygenation (ECMO) to improve gas exchange in patients with severe acute respiratory distress syndrome (ARDS). However, in some patients, long-term durability is limited due to fibrous and cellular accumulations on the gas exchange surface which can increase resistance to blood flow and diffusion path. These surface deposits of PMP MO after removal were studied with scanning electron and fluorescence microscopy techniques. Three of 31 patients supported by a PMP MO in an ECMO setting required a replacement of the oxygenator after a mean support interval of 11 +/- 7 days due to an increase in flow resistance and an impairment of the gas exchange capacity. The membrane surface of the MO was covered with a fibrous network with imbedded platelets and red blood cells. A membranous structure composed of single cells and clusters of cells covered large areas of the PMP fibers. We assume that these cellular deposits lower the efficacy of ECMO. The identification of these cells could be a key for future therapeutic interventions and improvements in the development of MO. ASAIO journal 2008; 54:612-617.