肺动脉-左心房无泵肺辅助对急性肺损伤动物模型右心室负荷影响

Influence of pulmonary artery-left atrium pumpless pulmonary assist on right ventricular load in oleic-induced acute lung injury animal model

目的:探讨肺动脉-左心房无泵肺辅助对幼猪急性肺损伤动物模型右心室负荷的影响,明确该辅助策略的可行性。方法:12只健康实验用中华小型猪以油酸诱导急性肺损伤模型后,随机分为2组:对照组6只,急性肺损伤模型建立后,仅给予常规机械通气;肺辅助组6只,常规机械通气,肺动脉-左心房无泵肺辅助。监测2组中心静脉压、肺动脉压、心输出量和辅助循环流量。结果:对照组肺动脉压呈持续性升高,至E时点肺动脉压升高至(40.9±9.0)mmHg,明显高于B时点(P=0.005)。肺辅助组于B时点开始肺辅助后,可见到血液流经辅助装置;肺动脉压呈下降趋势,至E时点降至(25.3±1.9)mmHg,明显低于B时点(P=0.047);对照组和肺辅助组D时点和E时点肺动脉压差异有统计学意义(P=0.002)。结论:肺动脉-左心房无泵肺辅助不增加急性肺损伤时右心室额外负荷,且有利于卸载右心室后负荷。

Objective To investigate the influence of pulmonary artery-left atrium pumpless pulmonary assist on right ventricular load in oleic-induced acute lung injury piglet model in order to identify its feasibility.Methods Twelve piglets were randomly divided into two groups after acute lung injury.Control group （n=6） received mechanical ventilation without lung assist.The experimental group （n=6） received pulmonary artery-left atrium pumpless pulmonary assist in which the membrane oxygenator was connected in parallel with the native lungs.The hemodynamic parameters and flow rate of assist circle were monitored.Results Pulmonary artery pressure increased progressively in control group until it reached （40.9±9.0）mm Hg at the time of E point,which was significantly higher than B point （P=0.005）.Blood flowing through assist device was visible since the beginning of lung assisting at the time of B point in the experimental group,pulmonary artery pressure showed decreasing tendency and it reached （25.3±1.9） mm Hg at E point,which was significantly lowerthan B point （P=0.047）.There was significant difference in pulmonary artery pressure at D point,E point,respectively,between in the experimental group and contol group.Conclusion The pulmonary artery-left atrium lung assist is feasible to treat acute lung injury,and can reduce the afterload of right ventricle.