Phototherapy and extracorporeal membrane oxygenation facilitate removal of carbon monoxide in rats
Phototherapy and extracorporeal membrane oxygenation facilitate removal of carbon monoxide in rats
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DOI：
10.1126/scitranslmed.aau4217
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发表时间：
2019-10
影响因子：
17.1
通讯作者：
L. Zazzeron;A. Fischbach;W. Franco;W. Farinelli;F. Ichinose;D. Bloch;R. R. Anderson-R.;W. Zapol
中科院分区：
文献类型：
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作者：
L. Zazzeron;A. Fischbach;W. Franco;W. Farinelli;F. Ichinose;D. Bloch;R. R. Anderson-R.;W. Zapol
体外血液光疗增加大鼠一氧化碳消除，提高相关肺损伤动物的存活率。一氧化碳（CO）是一种无色无味的气体，吸入后会导致严重的疾病和死亡。进入血液后，一氧化碳取代血红蛋白上的氧，减少外周组织的氧合。当一氧化碳中毒与肺损伤相关时，100%氧气治疗可能无效。利用先前的研究表明，可见光能够将血红蛋白与一氧化碳分离，现在，Zazzeron等人开发了一种体外膜氧合器，用于血液暴露于可见光下。使用光疗体外去除CO，与100%吸氧相比，CO中毒大鼠模型中CO的去除量增加，并且当CO中毒与肺损伤相关时，生存率提高。吸入的一氧化碳（CO）取代血红蛋白中的氧气，降低血液携带氧气的能力。目前对一氧化碳中毒患者的治疗包括给予100%氧气；然而，当一氧化碳中毒与继发于烟雾吸入、烧伤或创伤的急性肺损伤有关时，呼吸100%的氧气可能无效。可见光使一氧化碳与血红蛋白分离。我们假设血液在通过膜氧合器时暴露在可见光下会增加体内CO的消除速度。我们开发了一种具有最佳特性的膜氧合器，以促进血液暴露于可见光下，并在CO中毒大鼠模型中对该装置进行了测试，并伴有或不伴有肺损伤。与100%氧气通气相比，添加体外脱除一氧化碳光疗（ECCOR-P）可使正常肺CO中毒大鼠的CO消除率增加一倍。在CO中毒的急性肺损伤大鼠中，与单独100%氧气通气相比，ecco -p治疗使CO去除率提高了三倍，并与生存率提高有关。进一步发展和适应这种体外一氧化碳光去除装置用于临床，可能为一氧化碳中毒患者，特别是并发急性肺损伤的患者提供额外的益处。
Extracorporeal blood phototherapy increases carbon monoxide elimination in rats and improves survival in animals with associated lung injury. Shining the light on blood Carbon monoxide (CO) is a colorless, odorless gas that can cause severe illness and death after inhalation. After entering the bloodstream, CO replaces oxygen on hemoglobin, reducing oxygenation to peripheral tissues. When CO poisoning is associated with lung injury, treatment with 100% oxygen might not be effective. Leveraging previous studies showing that visible light was able to dissociate hemoglobin from CO, now, Zazzeron et al. developed an extracorporeal membrane oxygenator for blood exposure to visible light. The use of extracorporeal removal of CO using phototherapy, increased CO removal compared to 100% oxygen inhalation in rat model of CO poisoning and increased survival when CO poisoning was associated with lung injury. Inhaled carbon monoxide (CO) displaces oxygen from hemoglobin, reducing the capacity of blood to carry oxygen. Current treatments for CO-poisoned patients involve administration of 100% oxygen; however, when CO poisoning is associated with acute lung injury secondary to smoke inhalation, burns, or trauma, breathing 100% oxygen may be ineffective. Visible light dissociates CO from hemoglobin. We hypothesized that the exposure of blood to visible light while passing through a membrane oxygenator would increase the rate of CO elimination in vivo. We developed a membrane oxygenator with optimal characteristics to facilitate exposure of blood to visible light and tested the device in a rat model of CO poisoning, with or without concomitant lung injury. Compared to ventilation with 100% oxygen, the addition of extracorporeal removal of CO with phototherapy (ECCOR-P) doubled the rate of CO elimination in CO-poisoned rats with normal lungs. In CO-poisoned rats with acute lung injury, treatment with ECCOR-P increased the rate of CO removal by threefold compared to ventilation with 100% oxygen alone and was associated with improved survival. Further development and adaptation of this extracorporeal CO photo-removal device for clinical use may provide additional benefits for CO-poisoned patients, especially for those with concurrent acute lung injury.