Effects of Synchronous Pulsatile Extracorporeal Membrane Oxygenation in and Fetal Lamb

研究了同步搏动式体外膜氧合（ECMO）与常规非搏动式体外膜氧合的效果。8只胎羊羔在剖宫产后立即进行体外膜肺氧合。其中4例采用搏动性ECMO，其余4例采用非搏动性ECMO。60分钟后，给予L-NMMA (1mg/kg)，再进行60分钟的研究。搏动组的血压峰值、动脉pH值、碱过量、心排血量、肾血流量和肾组织流量均高于无搏动组，尤其是L-NMMA用药后。搏动组血浆去甲肾上腺素水平明显低于非搏动组。这些结果表明，搏动ECMO可能为胎儿羔羊提供更有效的心肺支持，并提示一氧化氮可能在胎儿循环中发挥重要作用。

Effects of synchronous pulsatile extracorporeal membrane oxygenation (ECMO) was studied using a fetal lamb, compared with conventional nonpulsatile ECMO.Eight fetal lambs were placed on ECMO immediately after cesarian section. Four were placed on pulsatile ECMO and the others were on nonpulsatile ECMO.After 60 min., they were given L-NMMA (1mg/kg) and were studied for an additional 60 min. Peak blood pressure, arterial pH,base excess, cardiac output, renal blood flow and renal tissue flow were higher in the pulsatile group than in the nonpulsatile group especially after the administration of L-NMMA.Plasma levels of noradrenaline were significantly lower in the pulsatile group than in the nonpulsatile group.These results indicate that pulsatile ECMO may provide more effective cardiopulmonary support in a fetal lambs and suggest that nitric oxide may play important role in fetal circulation.