Systemic oxygen delivery by peritoneal perfusion of oxygen microbubbles.
Systemic oxygen delivery by peritoneal perfusion of oxygen microbubbles.
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DOI：
10.1016/j.biomaterials.2013.12.070
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发表时间：
2014-03
期刊：
影响因子：
14
通讯作者：
Terry BS
中科院分区：
文献类型：
--
作者：
Feshitan JA;Legband ND;Borden MA;Terry BS
在危重病人中，对肺机械通气无效的严重低氧血症仍然危及生命。腹膜通气法长期以来一直是肺外氧合的理想选择，因为腹膜通气法易于进入腹膜腔进行插管，而且与体外循环相比具有相对的安全性。不幸的是，以前的尝试包括直接氧气通风或氟碳化合物或血红蛋白载体的含水灌流液，但都失败了，导致许多研究人员放弃了这种方法。我们将这些先前的失败归因于限制了氧气向腹膜的传质，并设计了一种克服这一限制的氧气配方。使用磷脂包裹的氧气微泡(OMBs)，我们证明了经历急性肺创伤的大鼠100%存活到至少2小时。相比之下，所有未治疗的大鼠和接受腹膜充氧生理盐水治疗的大鼠在30分钟内死亡。对于接受OMBs治疗的大鼠，在2小时的时间范围内，血红蛋白饱和度和心率处于正常水平。因此，使用OMBs进行腹膜氧合被证明是安全和有效的，而且该方法需要的设备和技术专业知识比启动和维护体外循环更少。进一步翻译腹膜氧合与OMBs可能为创伤、败血症、肺炎、吸入、烧伤和其他肺部疾病引起的急性呼吸窘迫综合征提供治疗。
Severe hypoxemia refractory to pulmonary mechanical ventilation remains life-threatening in critically ill patients. Peritoneal ventilation has long been desired for extrapulmonary oxygenation owing to easy access of the peritoneal cavity for catheterization and the relative safety compared to an extracorporeal circuit. Unfortunately, prior attempts involving direct oxygen ventilation or aqueous perfusates of fluorocarbons or hemoglobin carriers have failed, leading many researchers to abandon the method. We attribute these prior failures to limited mass transfer of oxygen to the peritoneum and have designed an oxygen formulation that overcomes this limitation. Using phospholipid-coated oxygen microbubbles (OMBs), we demonstrate 100% survival for rats experiencing acute lung trauma to at least 2 h. In contrast, all untreated rats and rats treated with peritoneal oxygenated saline died within 30 min. For rats treated with OMBs, hemoglobin saturation and heart rate were at normal levels over the 2-h timeframe. Peritoneal oxygenation with OMBs was therefore shown to be safe and effective, and the method requires less equipment and technical expertise than initiating and maintaining an extracorporeal circuit. Further translation of peritoneal oxygenation with OMBs may provide therapy for acute respiratory distress syndrome arising from trauma, sepsis, pneumonia, aspiration, burns and other pulmonary diseases.
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影响因子：
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