Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation
Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation
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DOI：
10.1378/chest.130.2.402
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发表时间：
2006-08-01
期刊：
影响因子：
9.6
通讯作者：
Friedberg, Joseph S.
中科院分区：
文献类型：
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作者：
Carr, Shamus R.;Cantor, Joshua P.;Friedberg, Joseph S.
背景：尽管给予了最大限度的呼吸支持，但许多患者在潜在可逆性肺衰竭的情况下死于缺氧。仍然迫切需要额外的肺部支持护理措施，特别是不需要全身抗凝的技术。我们的实验的目的是确定是否可以增加全身氧合在一个大型动物，诱导缺氧，通过灌注腹腔与氧合全氟化碳。方法：15头猪，平均（+/- SD）体重为45 +/-5 kg被插管，并通过用氮气和氧气的混合物通气使其缺氧，以达到低于大气压的吸入氧气浓度，从18%至10%，导致基线平均Pao（2）范围分别为65.9 +/- 9.7至26.6 +/- 2.8 mm Hg。在8只动物和7只对照动物中进行了腹膜灌注，其中8只动物使用氧合全氟化碳，7只动物使用氧合盐水溶液。结果：与氧合盐水溶液灌注相比，氧合全氟化碳灌注的Pao（2）平均增加8.1至18.2 mm Hg。在所有吸入氧分数（FIO 2）值中估计了一种常见的治疗效果，代表了含氧全氟化碳和生理盐水之间的摄氧量的平均差异，而与水平无关。FIO 2。该平均值为12.8 mm Hg（95%置信区间，7.4 - 18.2; p < 0.001）。最具临床相关性的结果发生在FIO 2为14%时，导致氧合生理盐水灌注的基线平均Pao（2）为39.4 +/- 5.0 mm Hg，氧合全氟化碳灌注的平均Pao（2）为55.3 +/- 7.6 mm Hg。这相当于动脉血氧饱和度从73%增加到89%。结论：我们的原理实验的这些结果表明，腹膜腔可以用于气体交换，并且在我们的模型中，产生了临床相关的全身动脉血氧水平的增加。这项技术可能有潜力的支持性护理的患者死于缺氧的设置可逆性肺损伤。
Background: Despite maximal ventilatory support, many patients die from hypoxia in the setting of potentially reversible pulmonary failure. There remains a pressing need for additional pulmonary supportive care measures, especially techniques that do not require systemic anticoagulation. The objective of our experiments was to determine whether systemic oxygenation could be increased in a large animal, with induced hypoxia, by perfusing the abdominal cavity with oxygenated perfluorocarbons.Methods: Fifteen pigs with a mean (+/- SD) weight of 45 +/- 5 kg were intubated and rendered hypoxic by ventilating them with a blend of nitrogen and oxygen to achieve subatmospheric concentrations of inspired oxygen ranging from 18 to 10%, resulting in baseline mean Pao(2) range of 65.9 +/- 9.7 to 26.6 +/- 2.8 mm Hg, respectively. Peritoneal perfusion was performed in eight animals with oxygenated perfluorocarbon and in seven control animals with oxygenated saline solution.Results: The average increase in Pao(2) with oxygenated perfluorocarbon perfusion, compared to oxygenated saline solution perfusion, ranged from 8.1 to 18.2 mm Hg. A common treatment effect was estimated across all fraction of inspired oxygen (FIO2) values, representing the average mean difference in oxygen uptake between oxygenated perfluorocarbon and saline solution, irrespective of the level of. FIO2. This average was 12.8 mm Hg (95% confidence interval, 7.4 to 18.2; p < 0.001). The most clinically relevant results occurred at an FIO2 of 14%, resulting in a baseline mean Pao(2) of 39.4 +/- 5.0 mm Hg with oxygenated saline solution perfusion, and a mean Pao(2) of 55.3 +/- 7.6 mm Hg with oxygenated perfluorocarbon perfusion. This corresponded to an increase in arterial oxygen saturation from 73 to 89%.Conclusion: These results of our principle experiments demonstrate that the peritoneal cavity can be used for gas exchange and, in our model, yielded clinically relevant increases in systemic arterial oxygen levels. This technique may have the potential for the supportive care of patients dying from hypoxia in the setting of reversible lung injury.