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

本研究旨在探讨体外膜氧合(ECMO)和外源性脂多糖(LPS)刺激对肾上腺髓质素(ADM)代谢和肺组织含水量的影响。12只体重3~4 kg的幼犬行ECMO，尿流率40ml/kg/min。稳定后，将幼犬分为低流量组(40只)和高流量组(100ml/kg/min)，观察240min。ECMO运行120min后，两组均注射内毒素5 mg/kg(055：B5，Westphal型)。ECMO组大鼠血浆ADM水平升高，肺组织ADM萃取量减少。高流量组大鼠血浆ADM水平进一步升高，高流量组大鼠肺组织含水量增加。提示ECMO和内毒素激发可引起新生儿ECMO时血中ADM水平升高，从而导致肺部并发症的发生。

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.