Total liquid ventilation provides superior respiratory support to conventional mechanical ventilation in a large animal model of severe respiratory failure.
Total liquid ventilation provides superior respiratory support to conventional mechanical ventilation in a large animal model of severe respiratory failure.
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DOI：
10.1097/mat.0b013e3182018a9f
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发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Hirschl RB
中科院分区：
文献类型：
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作者：
Pohlmann JR;Brant DO;Daul MA;Reoma JL;Kim AC;Osterholzer KR;Johnson KJ;Bartlett RH;Cook KE;Hirschl RB
在急性呼吸窘迫综合征（ARDS）中，全液体通气（TLV）提供的呼吸支持可能上级常规机械通气（CMV）。然而，实验室研究仅限于在小动物中进行不超过4小时的试验。本研究的目的是在大型ARDS动物模型中比较TLV和CMV 24小时。将10只体重为53 ± 4（SD）kg的绵羊麻醉，并用100%氧气通气。将油酸注射到肺循环中，直至PaO2：FiO2 ≥ 60 mmHg，然后过渡到保护性CMV方案（n=5）或TLV（n=5），持续24小时。记录病理生理学并收获肺用于组织学分析。尽管给予了最大程度的呼吸支持，但接受CMV治疗的动物仍逐渐出现缺氧和高碳水化合物。与CMV组相比，TLV组绵羊的血气保持正常，PO2（p<10−9）和PCO2（p < 10−3）在统计学上更高。TLV组和CMV组24小时存活率分别为100%和40%（p< 0.05）。因此，在严重ARDS的实验室模型中，TLV提供的气体交换上级优于CMV。
Total liquid ventilation (TLV) has the potential to provide respiratory support superior to conventional mechanical ventilation (CMV) in the acute respiratory distress syndrome (ARDS). However, laboratory studies are limited to trials in small animals for no longer than 4 hours. The objective of this study was to compare TLV and CMV in a large animal model of ARDS for 24 hours. Ten sheep weighing 53 ± 4 (SD) kg were anesthetized and ventilated with 100% oxygen. Oleic acid was injected into the pulmonary circulation until PaO2:FiO2 ≥ 60 mmHg, followed by transition to a protective CMV protocol (n=5) or TLV (n=5) for 24 hours. Pathophysiology was recorded and the lungs were harvested for histological analysis. Animals treated with CMV became progressively hypoxic and hypercarbic despite maximum ventilatory support. Sheep treated with TLV maintained normal blood gases with statistically greater PO2 (p<10−9) and lower PCO2 (p < 10−3) than the CMV group. Survival at 24 hours in the TLV and CMV groups were 100% and 40% respectively (p< 0.05). Thus, TLV provided gas exchange superior to CMV in this laboratory model of severe ARDS.