Total pulmonary liquid instillation under extracorporeal lung assist in dogs

犬体外肺辅助下全肺液体灌注

• 批准号: 05454424
• 负责人: TERASAKI Hidenori
• 金额: $ 4.74万
• 依托单位: KUMAMOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05454424/
• 关键词: Respiratory failure; Extracorporeal lung assist; Extracorporeal circulation; Pulmonary liquid instillation; Pulmonary lavage; Artificial membrane lung; Total bypass; Veno-arterial bypass; 体外式心肺補助

Extracorporporeal lung and heart assist (ECLHA) , which is prolonged cardiopulmonary bypass with an artifiaial membrane lung, is one of most effective life support means for patients with severe respiratory failure refractory to the conventional therapy. We examined if ECLHA could support the total pulmonary liquid instillation and lavage in anesthetized dogs, to open a new therapeutic modality to wash out wash out inflammatory substances accumulated in the alveolar space of acute respiratory distress syndrome (ARDS). In sixteen dogs (8 to 13 kg of body weight) , a veno-arterial ECLHA provided a bypass blood flow rate of 1,206? B1198 ml/min (mean? B1SD) through the peripheral blood accesses placed into the carotid artey and jugular vein, then we filled the lungs of dogs with the lactate Ringer's solution of 500 to 700 ml under a pressure controlled less than 30 cm H_2O.In a half of the dogs, however, the bypass blood flow rate decreased gradually, hemodynamics deterioreted for a period … More of 24 hours of the lung instillation because in animal study optimal blood transfusion was not available to restore the blood volume. In the remaining 8 animals, ECLHA could sustain the good gas exchange and circulation without particpating in respiration of the normal lungs for 24 hours. Autopsy revealed massive pleural effusion and ascites in all animals that might result from unavoidable hypoproteinemia in no-dlood ECLHA.This study suggested feasibility of the new pulmonary lavage combined with ECLHA,if normal vascular permeability could maintained. Therefore, in the next study we tested effects of prostaglandin (PCE_1) on vascular permeability by measuring the changes in the body weigth of animals undergone ECLHA of 24 hours. We found no singificant difference between the PCE_1 group and control group with regard to body weight, urine output and plasmaprotein. Further studies have to be carried out to establish the pulmonary instillation combined with ECLHA as a new respiratory treatment. Less

体外肺和心脏辅助（ECLHA）用人造膜肺延长心肺旁路，是对常规疗法难治性严重呼吸衰竭患者的最有效的生命支持之一。我们检查了ECLHA是否可以支持麻醉犬中的肺液体液体滴注和灌洗，以打开一种新的治疗方式，以洗涤在急性呼吸遇险综合征（ARDS）肺泡空间中积累的洗涤炎性物质。在16只狗（体重8至13公斤）中，静脉ECLHA的旁路流量为1,206？ B1198 mL/min（平均？B1SD）通过放入颈动脉Artey和颈静脉中的外周血征收，然后我们用乳酸铃声的溶液填充了狗的肺500至700 ml在压力下的溶液中，狗的H_2o降低了30 cm的降低。滴注是因为在动物研究中，最佳输血无法恢复血液量。在其余的8只动物中，ECLHA可以维持良好的气体交换和循环，而无需进行正常肺呼吸24小时。尸检显示，所有动物中的大量胸腔积液和腹水大规模腹部可能是由于无含量ECLHA中不可避免的低蛋白血症所致。这项研究表明，如果正常的血管通渗透油可以维持正常的血管渗透性，则新的肺部提供ECLHA的可行性与ECLHA相结合。因此，在下一项研究中，我们测试了前列腺素（PCE_1）对血管渗透性的影响，通过测量动物的体重变化24小时。我们发现PCE_1组与对照组之间没有单一的差异，尿液输出和静脉蛋白质。必须进行进一步的研究，以建立与ECLHA作为新呼吸治疗的肺部滴注。较少的

项目成果

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Okamoto T: "Safety of high-dose of nafamostat mesilate-toxicological study in beagles-" J Pharmacol Exp Ther. 268 (2). 639-644 (1994)

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Okamoto,T: "Sagety of high-dose of nafamostat mesilate-toxicological study in beables-" J Pharmacol Exp Ther. 268. 639-644 (1994)

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