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）挑战对白细胞活化程度的影响，通过血液中细胞因子的释放来测量。对8只体重3 ~ 4 kg的幼犬进行体外膜肺氧合（ECMO），流速为100 ml/kg/min。稳定后，将幼犬分为2组，每组210 mm: Ex组，4只幼犬，静脉注射LPS （055: B5， Westphal型）5 mg/kg；E组为4只未注射LPS的幼犬。Ex组大鼠白细胞计数、收缩压、心输出量显著降低，血清乳酸、肾上腺素、去甲肾上腺素、多巴胺显著升高。Ex组大鼠血清白细胞介素(IL)-1 β水平显著升高，但两组大鼠血清肿瘤坏死因子(TNF) α、IL-6、血小板活化因子（PAF）水平无显著变化。这些结果表明，ECMO制度可能会降低血液中细胞因子的水平，这可能导致新生儿ECMO循环和器官功能衰竭。

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.