The efficacy of partial liquid ventilation on lung protection during hypotension and cardiac arrest

基本原理：我们先前报道了部分液体通气（PLV）抑制实验性兔模型心脏骤停时的肺损伤。我们接下来研究了PLV在无心跳供体肺移植中供体肺保护的功效。方法：我们使用了11组雌性比格犬，并分为两组：（a）常规通气（GV，n=6），（B）部分液体通气（PLV，n=5）。维持1小时低血压低于50 mmHg，随后心脏停搏2小时，进行常规通气或PLV通气。常规通气下行左供肺切取及左单肺移植术。在研究期间，连续检测动脉血气分析、肺阻力和肺弹性以及组织中白细胞介素-8（IL-8）浓度。观察供体肺组织学并进行组织学评分。在3例（GV：n=1，PLV：n=2）中， ...更多信息 结果：实验期间两组动脉血氧分压无显著性差异（P > 0. 05），两组动脉血氧分压无显著性差异（P > 0. 05）。移植后两组组织学评分均逐渐升高，GV组移植后6 h评分明显高于PLV组。肺阻力和弹性在研究期间逐渐增加，直到肺回收，GV组和PLV组之间没有显著差异。IL-8在研究期间在两组中维持其与基线水平相同的值，并且两组之间没有统计学差异。根据移植后弹性蛋白、阻力及组织学评分结果，组织学评分与弹性蛋白、阻力有相关性。结论：组织学分析提示PLV可抑制肺损伤。组织学评分与弹性蛋白、抵抗力相关。弹性或阻力的测定有可能成为肺损伤的评价方法之一。少

Rationale : We previously reported that partial liquid ventilation (PLV) suppressed lung injury during cardiac arrest in the experimental rabbit model. We next investigated the efficacy of PLV in donor lung protection in lung transplantation from non-heart beating donors.Methods : We utilized eleven sets of female beagle dogs and divided into two groups : (a) conventional ventilation (GV, n=6), (b) partial liquid ventilation (PLV, n=5). While one-hour hypotension less than 50mmHg followed by 2-hour cardiac arrest was maintained, conventional ventilation or PLV had been performed for ventilation. Left donor lung retrieval and left single lung transplantation under conventional ventilation were performed. During the study period, arterial blood gas analysis, pulmonary resistance and elastance, and tissue Interleukin-8 (IL-8) concentration were serially measured. Donor lung histology was observed and assessed with histological evaluation scores. In 3 cases (GV:n=1, PLV:n=2) pulmonary resi … More stance and elastacne were measured even after the transplantation until the end of experiment.Results : There was no significant difference in arterial oxygen tension between the two groups during the study period. Histological evaluation score in both groups elevated gradually after transplantation, and the GV group showed its score at 6 hours after transplantation significantly higher than the PLV group. Pulmonary resistance and elastance gradually increased during the study period until lung retrieval, and there was no significant difference between the GV group and PLV group. IL-8 maintained its value as high as baseline level during the study period in both groups and there was no statistical difference between the two groups. According to the results of elastacne, resistance and histological evaluation score after the transplantation, there was correlation between histological scores and elastance or resistance.Conclusion : The histological analysis suggested PLV suppresses lung injury. There was correlation between the histological score and elastacne or resistance. And there is a possibility that the measurement of elastance or resistance might be one of the methods for the evaluation of lung injury. Less