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首页> 外文期刊>Artificial Organs >Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure
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Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure

机译：仔猪急性心脏衰竭模型中体外脉搏膜氧合对血流动力学能量和全身微循环的影响

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摘要

The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08 +/- 0.86 kg were divided into pulsatile (N = 7) and nonpulsatile (N = 7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house. Nonpulsatile ECMO was initiated at a flow rate of 140 mL/kg/min for the first 30 min with normal heart beating, with rectal temperature maintained at 36 degrees C. Ventricular fibrillation was then induced with a 3.5-V alternating current to generate a cardiac dysfunction model. Using this model, we collected the data on pulsatile and nonpulsatile groups. The piglets were weaned off ECMO at the end of the experiment (180 min after ECMO was initiated). The animals did not receive blood transfusions, inotropic drugs, or vasoactive drugs. Blood samples were collected to measure hemoglobin, methemoglobin, blood gases, electrolytes, and lactic acid levels. Hemodynamic energy was calculated using the Shepard's energy equivalent pressure. Near-infrared spectroscopy was used to monitor brain and kidney perfusion. The pulsatile ECMO group had a higher atrial pressure (systolic and mean), and significantly higher regional saturation at the brain level, than the nonpulsatile group (for both, P < 0.05). Additionally, the pulsatile ECMO group had higher methemoglobin levels within the normal range than the nonpulsatile group. Our study demonstrated that pulsatile ECMO produces significantly higher hemodynamic energy and improves systemic microcirculation, compared with nonpulsatile ECMO in acute cardiac failure.
机译：这项研究的目的是比较仔猪急性心力衰竭模型中搏动性和非搏动性体外膜氧合（ECMO）对血液动力和全身微循环的影响。将平均体重为6.08 +/- 0.86千克的14头仔猪分为搏动型（N = 7）和非搏动型（N = 7）ECMO组。 ECMO实验回路由内部开发的离心泵，膜式充氧器和气动脉动流发生器系统组成。在最初的30分钟内以正常心脏跳动以140 mL / kg / min的流速启动无搏动ECMO，并将直肠温度维持在36摄氏度。然后用3.5 V交流电诱发心室纤颤，从而产生心脏功能障碍模型。使用此模型，我们收集了搏动和非搏动组的数据。实验结束时（启动ECMO后180分钟）将仔猪断奶。动物没有接受输血，正性肌力药物或血管活性药物。收集血液样本以测量血红蛋白，高铁血红蛋白，血液气体，电解质和乳酸水平。使用谢泼德的能量当量压力计算血流动力学能量。近红外光谱用于监测脑和肾脏的灌注。与非搏动组相比，搏动性ECMO组的心房压（收缩压和均值）更高，并且在大脑水平上的区域饱和度显着更高（两者均P <0.05）。此外，搏动性ECMO组在正常范围内的高铁血红蛋白水平高于非搏动性组。我们的研究表明，与非搏动性ECMO相比，搏动性ECMO与急性心力衰竭相比可产生更高的血液动力，并改善了全身微循环。

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