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首页> 外文期刊>Artificial Organs >Hemocompatibility of a miniaturized extracorporeal membrane oxygenation and a pumpless interventional lung assist in experimental lung injury.
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Hemocompatibility of a miniaturized extracorporeal membrane oxygenation and a pumpless interventional lung assist in experimental lung injury.

机译：微型体外膜氧合和无泵介入性肺的血液相容性有助于实验性肺损伤。

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Extracorporeal membrane oxygenation (ECMO) is used for most severe acute respiratory distress syndrome cases in specialized centers. Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arteriovenous perfusion of a low-resistance oxygenator without a blood pump (Novalung, Hechingen, Germany) or a miniaturized ECMO with reduced filling volume and a diagonal blood pump (Deltastream, Medos AG, Stolberg, Germany) could optimize hemocompatibility. The aim of the study was to compare hemocompatibility with conventional ECMO. Female pigs were connected to extracorporeal circulation for 24 h after lavage induced lung injury (eight per group). Activation of coagulation and immune system as well as blood cell damage was measured. A P value <0.05 was considered significant. Plasmatic coagulation was slightly activated in all groups demonstrated by increased thrombin-anti-thrombin III-complex. No clinical signs of bleeding or thromboembolism occurred. Thrombelastography revealed decreased clotting capacities after miniaturized ECMO, probably due to significantly reduced platelet count. These resulted in reduced dosage of intravenous heparin. Scanning electron microscopy of oxygenator fibers showed significantly increased binding and shape change of platelets after interventional lung assist. In all groups, hemolysis remained negligible, indicated by low plasma hemoglobin concentration. Interleukin 8 and tumor necrosis factor-alpha concentration as well as leukocyte count remained unchanged. Both devices demonstrated adequate hemocompatibility for safe clinical application, although a missing blood pump did not increase hemocompatibility. Further studies seem necessary to analyze the influence of different blood pumps on platelet drop systematically.
机译：体外膜氧合（ECMO）用于专门中心的大多数严重急性呼吸窘迫综合征病例。设备的血液相容性取决于血液接触表面的大小和变化以及血液流速。在不使用血泵的情况下，通过低阻力充氧器的动静脉灌注进行介入性肺辅助治疗（Novalung，Hechingen，德国），或者在充血量减少的情况下使用微型ECMO和对角血泵（Deltastream，Medos AG，​​Stolberg，德国）可以优化血液相容性。该研究的目的是比较血液相容性与常规ECMO。灌洗引起的肺损伤后，雌猪与体外循环相连接24小时（每组八只）。测量了凝血和免疫系统的激活以及血细胞损伤。 P值＜0.05被认为是显着的。凝血酶-抗凝血酶III-复合物增加表明，所有组的血浆凝血均被轻微激活。没有发生出血或血栓栓塞的临床迹象。血流弹性示图显示ECMO缩小后凝血能力下降，可能是由于血小板数量明显减少所致。这些导致静脉内肝素剂量的减少。氧合剂纤维的扫描电子显微镜显示介入肺辅助后血小板的结合和形状改变显着增加。在所有组中，血浆血红蛋白浓度低均表明溶血作用可忽略不计。白细胞介素8和肿瘤坏死因子-α浓度以及白细胞计数保持不变。两种设备均具有足够的血液相容性，可用于安全的临床应用，尽管缺少血泵不会增加血液相容性。似乎有必要进行进一步的研究以系统地分析不同血泵对血小板下降的影响。

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