Effects of Synchronous Pulsatile Extracorporeal Membrane Oxygenation in and Fetal Lamb

为探讨同步脉动体外膜肺氧合(ECMO)对胎羊的影响，将8只胎羊剖宫产后立即置入ECMO，并与常规非搏动ECMO进行比较。将4只大鼠置于脉动型ECMO上，其余4只置于非脉动型ECMO上，60min后给予L-NMMA(1 mg/kg)，继续观察60min。搏动性组的峰值血压、动脉pH、碱值、心输出量、肾血流量和肾组织流量均高于非搏动性组，尤其是在应用L-NMMA后。血浆去甲肾上腺素水平显著低于非搏动性组。这些结果表明，搏动性体外膜氧合可能对胎羊的心肺功能提供更有效的支持，并提示一氧化氮在胎儿循环中可能起重要作用。

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.