213 Extrapulmonary Gas Exchange Through Peritoneal Perfluorocarbon Perfusion
213 Extrapulmonary Gas Exchange Through Peritoneal Perfluorocarbon Perfusion
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DOI：
10.1017/cts.2022.115
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发表时间：
2022-04-19
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
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作者：
目标：对于呼吸衰竭患者，除了机械通气外，支持气体交换的选择有限。我们的目标是设计，调查，并完善一种新的装置，肺外气体交换，通过腹膜灌注全氟化碳（PFC）的动物模型。方法/研究人群：将使用50 kg机械通气（含低于大气压（10-12%）氧气）的猪模拟低氧性呼吸衰竭。通过中线剖腹手术，将两个套管（一个用于流入，一个用于流出）置入腹膜间隙。腹部闭合后，将套管连接到能够引流、充氧、调节温度、过滤和以3-4升/分钟的速率泵送全氟萘烷的装置。在诱导缺氧期间，将通过有创（例如动脉和静脉血气）和无创测量（例如脉搏血氧仪）监测通过腹膜间隙的PFC循环的生理反应。结果/预期结果：我们预计，在诱导缺氧过程中，通过腹膜腔开始充氧全氟化碳灌注将导致动脉血中血红蛋白氧饱和度和氧分压增加。由于我们预期气体交换发生在腹膜的微血管床中，我们预期观察到从下腔静脉取样的静脉血氧含量增加。使用其他有创血流动力学指标（例如心输出量）和从多个静脉部位采集的血液样本，可计算可量化的氧气输送率。讨论/意义：如果能够输送大量氧气，腹膜全氟化碳灌注将为呼吸衰竭患者提供潜在的救生治疗，这些患者无法单独使用机械通气支持，并且不适合体外膜氧合。
OBJECTIVES/GOALS: For patients suffering from respiratory failure there are limited options to support gas exchange aside from mechanical ventilation. Our goal is to design, investigate, and refine a novel device for extrapulmonary gas exchange via peritoneal perfusion with perfluorocarbons (PFC) in an animal model. METHODS/STUDY POPULATION: Hypoxic respiratory failure will be modeled using 50 kg swine mechanically ventilated with subatmospheric (10-12%) oxygen. Through a midline laparotomy, two cannulas, one for inflow and one for outflow, will be placed into the peritoneal space. After abdominal closure, the cannulas will be connected to a device capable of draining, oxygenating, regulating temperature, filtering, and pumping perfluorodecalin at a rate of 3-4 liters per minute. During induced hypoxia, the physiologic response to PFC circulation through the peritoneal space will be monitored with invasive (e.g. arterial and venous blood gases) and non-invasive measurements (e.g. pulse oximetry). RESULTS/ANTICIPATED RESULTS: We anticipate that the initiation of oxygenated perfluorocarbons perfusion through the peritoneal space during induced hypoxia will create an increase in hemoglobin oxygen saturation and partial pressure of oxygen in arterial blood. As we expect gas exchange to be occurring in the microvascular beds of the peritoneal membrane, we expect to observe an increase in the venous blood oxygen content sampled from the inferior vena cava. Using other invasive hemodynamic measures (e.g. cardiac output) and blood samples taken from multiple venous sites, a quantifiable rate of oxygen delivery will be calculable. DISCUSSION/SIGNIFICANCE: Peritoneal perfluorocarbon perfusion, if able to deliver significant amounts of oxygen, would provide a potentially lifesaving therapy for patients in respiratory failure who are unable to be supported with mechanical ventilation alone, and are not candidates for extracorporeal membrane oxygenation.