Experimental Study for Pulmonary Complication in Neonatal ECMO : A Role of Adrenomedullin

本研究的目的是确定体外膜氧合（ECMO）和额外脂多糖（LPS）刺激对肺内肾上腺髓质素（ADM）代谢和肺含水量的影响。12只体重3 ~ 4 kg的幼犬采用ECMO，流速为40 ml/kg/min。稳定后，将幼犬分为流速40（低流量组）和100 ml/kg/min（高流量组）2组，研究240 min。ECMO运行120 min后，两组均注射LPS（055: B5， Westphal型）5 mg/kg。ECMO时血浆ADM水平升高，高流量组肺内ADM提取量降低。LPS处理后，ADM的血浆水平进一步升高。高流量组肺含水量最终增加。这些结果表明，ECMO的建立和LPS的刺激增加了血液中ADM的水平，这可能导致新生儿ECMO的肺部并发症。

The object of this study was to determine the effects of extracorporeal membrane oxygenation(ECMO)and additional lipopolysaccharide(LPS) challenge on the adrenomedullin(ADM)metabolism and the water content of the lung. ECMO was instituted in 12puppies weighing 3 to 4 kg with flow rate of 40 ml/kg/min. After stabilization, these puppies were divided into 2 groups with flow rate of 40(low flow group)and 100 ml/kg/min(high flow group)and studied for 240 min. After 120 min.of ECMO run, 5 mg/kg of LPS(055 : B5, Westphal type)was injected in both group. Plasma lebels of ADM were increased on ECMO and the extraction volume of ADM in lung was decreased in high flow group. Plasma lebels of ADM were further increased after administration of LPS.The water content of the lung was finally increased in high flow group. These results indicated that the institution of ECMO and LPS challenge increase the blood levels of ADM, which may cause pulmonary complications in neonatal ECMO.