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

体外循环心肺辅助（ECLHA）是一种延长体外循环时间的人工膜肺，是治疗常规治疗无效的严重呼吸衰竭的有效方法之一。本研究旨在探讨ECLHA能否支持麻醉犬的全肺液体灌注和灌洗，为急性呼吸窘迫综合征（ARDS）肺泡腔内炎症物质的清除提供一种新的治疗模式。在16只狗（8至13公斤的体重），静脉动脉ECLHA提供了旁路血流量为1,206？B1198 ml/min（平均值？B_（1 SD）经颈动脉和颈静脉建立外周血通道，然后在压力控制在30 cm H_2O以下的条件下，用乳酸林格氏液500 ~ 700 ml灌注犬肺，但有半数犬的转流率逐渐下降，血流动力学出现一段时间的异常 ...更多信息 因为在动物研究中没有最佳输血来恢复血容量。其余8只动物，ECLHA能维持正常肺24 h内良好的气体交换和循环，不参与呼吸。尸检显示所有动物均出现大量胸腔积液和腹水，这可能是无血ECLHA中不可避免的低蛋白血症造成的。本研究表明，如果能够维持正常的血管渗透性，新型肺灌洗联合ECLHA是可行的。因此，在接下来的研究中，我们通过测量经历ECLHA 24小时的动物体重的变化来测试前列腺素（PCE_1）对血管通透性的影响。PCE_1组与对照组相比，体重、尿量、血浆蛋白含量无显著性差异。肺灌注联合ECLHA作为一种新的呼吸系统治疗方法有待进一步研究。少

项目成果

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

Okatroto，T：“高剂量甲磺酸萘莫司他的安全性 - 比格犬的毒理学研究”J Pharmacol Exp Ther。

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

冈本 T：“高剂量甲磺酸萘莫司他的安全性 - 比格犬的毒理学研究 -”J Pharmacol Exp Ther。

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

Okamoto,T：“高剂量甲磺酸萘莫司他的 Sagety - 毒理学研究 -”J Pharmacol Exp Ther。

田尻晃彦: "救急蘇生用手動体外循環ポンプの溶血に対する作用" 麻酔. 43. 740-745 (1994)

Akihiko Tajiri：“手动体外循环泵对溶血的紧急复苏的影响”麻醉 43. 740-745 (1994)。

Sakanashi,Y: "A case of Eisenmener's syndrome treated with extracorporeal lung and heart assist in the postpartumperiod" Journal of Anesthesia. 8. 107-109 (1994)

Sakanashi,Y：“产后用体外肺和心脏辅助治疗艾森曼综合征的一例”《麻醉杂志》。