Experimental Study for Circulatory and Organs Failure in Neonatal ECMO

本研究的目的是确定体外膜氧合(ECMO)和额外的脂多糖(LPS)攻击对白细胞激活程度的影响，通过血液中细胞因子的释放来衡量。8只体重3~4 kg的幼犬行ECMO，尿流率为100ml/kg/min。稳定后，将这些幼犬分成两组，研究210 mm。组4只，静脉注射内毒素5 mg/kg(055：B5，Westphal型)，E组4只，不注射内毒素。外周血白细胞计数、收缩压、心输出量均明显低于对照组。血清乳酸、肾上腺素、去甲肾上腺素和多巴胺明显升高。两组大鼠血中肿瘤坏死因子(TNF)α、IL-6和血小板活化因子(PAF)水平均无明显变化，而血清IL-1β水平明显升高。提示ECMO可能通过降低血液中细胞因子的水平，导致新生儿ECMO发生循环衰竭和器官衰竭。

The object of this study was to determine the effects of extracorporeal membrane oxygenation (ECMO) and additional lipopolysaccharide (LPS) challenge on the degree of leukocyte activation, as measured by cytokine release in blood. ECMO was instituted in 8 puppies weighing 3 to 4 kg with flow rate of 100 ml/kg/min. After stabilization, these puppies were divided into 2 groups and studied for 210 mm. : Group Ex, consisted of 4 puppies, in which 5 mg/kg of LPS (055 : B5, Westphal type) was injected intravenously ; Group E, consisted of 4 puppies without LPS injection. White blood cell count, Systolic blood pressure and cardiac output were significantly decreased in Group Ex. Serum lactate, adrenaline, noradrenaline and dopamine were significantly increased in Group Ex. Although a significant increase of interleukin (IL)-1beta was observed in Group Ex, no significant change of blood levels of tumor necrosis factor (TNF) alpha, IL-6 and platelet-activating factor (PAF) was observed in both groups. These results indicated that the institution of ECMO may depress the blood levels of cytokines, which might cause circulatory and organs failure in neonatal ECMO.