Thanh bên bài viết

PDF
Ngày xuất bản: 31/07/2024
Ngày xuất bản Online: 31/07/2024
Số lượt xem tóm tắt: 163
Số lượt xem PDF: 47
DOI: https://doi.org/10.47972/vjcts.v47i.1152
Số xuất bản
Tập 47
Chuyên mục
Bài báo
Trích dẫn bài báo
Hideshi, I., Shingo, I., Hideaki, O., Midori, F., Shigeyuki, O., Teruyuki, K., Nguyen, T. B., & Le, N. T. (2024). Pulsatile Right Ventricle to Pulmonary Artery Extracorporeal Membrane Oxygenation in a Pigs. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 47, 5-16. https://doi.org/10.47972/vjcts.v47i.1152

Pulsatile Right Ventricle to Pulmonary Artery Extracorporeal Membrane Oxygenation in a Pigs

Hideshi ITOH , Shingo Ichiba, Hideaki Obata, Midori Futami, Shigeyuki Okahara, Teruyuki Kawabata, Nguyen The Binh, Le Ngoc Thanh

Nội dung chính của bài viết

Tóm tắt

Background: We investigated the impact of right ventricle to pulmonary artery extracorporeal membrane oxygenation in acute respiratory dysfunction with or without pulsatile flow.                                                     


Methods: We used bronchoalveolar lavage with intrapulmonary administration of warm saline to establish a severe acute respiratory distress syndrome model (ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration ratio <200) in eight piglets (mean body weight: 8.45±1.24 kg). The piglets were categorized into the pulsatile (N=4) and non-pulsatile extracorporeal membrane oxygenation groups (N=4). We started right ventricle to pulmonary artery extracorporeal membrane oxygenation with a 60 mL/kg/min flow to support the animals for 6 hours. We monitored hemodynamic data and blood gas levels for assessing base excess, and performed arterial blood sampling and electrocardiogram. Interleukin-6 and endotherlin-1 concentrations in blood plasma were evaluated before and after right ventricle to pulmonary artery extracorporeal membrane oxygenation. We compared the lung wet/dry weight ratio as a measure of pulmonary edema and collected lung tissue samples for the pathologically evaluating pneumocytes before and after right ventricle to pulmonary artery extracorporeal membrane oxygenation.                                          


Results: We maintained stable hemodynamics and extracorporeal membrane oxygenation flow above an arterial oxygen saturation of 85% in both groups. Pneumocyte evaluation showed clearly less pulmonary edema, pulmonary fibrosis, and inflammation. Interleukin-6 concentration was less in the pulsatile group than in the non-pulsatile group.                                           


Conclusions: Pulsatile right ventricle to pulmonary artery extracorporeal membrane oxygenation was less vasoconstrictive and maintained more effective oxygenated pulmonary flow. It ameliorates pulmonary circulation and facilitates recovery from acute respiratory failure.

Chi tiết bài viết

Từ khóa

Extracorporeal Membrane Oxygenation (ECMO), Acute Respiratory Distress Syndrome (ARDS), Right Ventricle to Pulmonary Artery (RV-PA), Pulsatile, Non-pulsatile

Tài liệu tham khảo

1. Mosier JM, Kelsey M, Raz Y, Gunnerson KJ, Meyer R, Hypes CD, et al. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Crit Care 2015; 19: 431.
2. Millar JE, Fanning JP, McDonald CI, McAuley DF, Fraser JF. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology. Crit Care 2016; 20: 387.
3. Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators, Davies A, Jones D, Bailey M, Beca J, Bellomo R, et al. Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 2009; 302: 1888–1895.
4. Barbaro RP, MacLaren G, Boonstra PS, Combes A, Agerstrand C, Annich G, et al. Extracorporeal membrane oxygenation for COVID-19: evolving outcomes from the international Extracorporeal Life Support Organization Registry. Lancet 2021; 398: 1230–1238.
5. Abrams D, Bacchetta M, Brodie D. Recirculation in venovenous extracorporeal membrane oxygenation. ASIAO J 2015; 61: 115–121.
6. Conrad SA, Wang D. Evaluation of recirculation during venovenous extracorporeal membrane oxygenation using computational fluid dynamics incorporating fluid-structure interaction. ASAIO J 2021; 67: 943–953.
7. Ündar A, Kunselman AR, Barbaro RP, Alexander P, Patel K, Thomas NJ. Centrifugal or roller blood pumps for neonatal venovenous extracorporeal membrane oxygenation: Extracorporeal Life Support Organization database comparison of mortality and morbidity. Pediatr Crit Care Med 2023; 24: 662–669.
8. Kim HK, Son HS, Fang YH, Park SY, Hwang CM, Sun K. The effects of pulsatile flow upon renal tissue perfusion during cardiopulmonary bypass: a comparative study of pulsatile and nonpulsatile flow. ASAIO J 2005; 51: 30–36.
9. Henderson WR, Barnbrook J, Dominelli PB, Griesdale DEG, Arndt T, Molgat-Seon Y, et al. Administration of intrapulmonary sodium polyacrylate to induce lung injury for the development of a porcine model of early acute respiratory distress syndrome. Intensive Care Med Exp 2014; 2: 5.
10. Robinson S, Peek G. The role of ECMO in neonatal & paediatiric patients. Paediatr Child Health 2015; 25: 222–227.
11. Extracorporeal Life Support Organization Registry report. ELSO, 2020.
12. Banavasi H, Nguyen P, Osman H, Soubani AO. Management of ARDS - what works and what does not. Am J Med Sci 2021; 362: 13–23.
13. Al-Fares AA, Ferguson ND, Ma J, Cypel M, Keshavjee S, Fan E, et al. Achieving safe liberation during weaning from VV-ECMO in patients with severe ARDS: the role of tidal volume and inspiratory effort. Chest 2021; 160: 1704–1713.
14. Palmér O, Palmér K, Hultman J, Broman M. Cannula design and recirculation during venovenous extracorporeal membrane oxygenation. ASAIO J 2016; 62: 737–742.
15. Maratta C, Potera RM, van Leeuwen G, Castillo Moya A, Raman L, Annich GM. Extracorporeal Life Support Organization (ELSO): 2020 Pediatric Respiratory ELSO guideline. ASAIO J 2020; 66: 975–979.
16. Dunham-Snary KJ, Wu D, Sykes EA, Thakrar A, Parlow LRG, Mewburn JD, et al. Hypoxic pulmonary vasoconstriction: from molecular mechanisms to medicine. Chest 2017; 151: 181–192.
17. Cardinal-Fernández P, Lorente JA, Ballén-Barragán A, Matute-Bello G. Acute respiratory distress syndrome and diffuse alveolar damage. New insights on a complex relationship. Ann Am Thorac Soc 2017; 14: 844–850.
18. Gierhardt M, Pak O, Walmrath D, Seeger W, Grimminger F, Ghofrani HA, et al. Impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome. Eur Respir Rev 2021; 30: 210059.
19. Heinrich PC, Behrmann I, Haan S, Hermanns HM, Müller-Newen G, Schaper F. Principles of interleukin (IL)-6-type cytokine signalling and its regulation. Biochem J 2003; 374: 1–20.
20. Ehlting C, Wolf SD, Bode JG. Acute-phase protein synthesis: a key feature of innate immune functions of the liver. Biol Chem 2021; 402: 1129–1145.
21. Yamamoto K, Sokabe T, Ohura N, Nakatsuka H, Kamiya A, Ando J. Endogenously released ATP mediates shear stress-induced Ca2+ influx into pulmonary artery endothelial cells. Am J Physiol Heart Circ Physiol 2003; 285: H793–H803.
22. Tu LN, Hsieh L, Kajimoto M, Charette K, Kibiryeva N, Forero A, et al. Shear stress associated with cardiopulmonary bypass induces expression of inflammatory cytokines and necroptosis in monocytes. JCI Insight 2021; 6: e141341.
23. Zegeye MM, Lindkvist M, Fälker K, Kumawat AK, Paramel G, Grenegård M, et al. Activation of the JAK/STAT3 and PI3K/AKT pathways are crucial for IL-6 trans-signaling-mediated pro-inflammatory response in human vascular endothelial cells. Cell Commun Signal 2018; 16: 55.
24. Li G, Zeng J, Liu Z, Zhang Y, Fan X. The pulsatile modification improves hemodynamics and attenuates inflammatory responses in extracorporeal membrane oxygenation. J Inflamm Res 2021; 14: 1357–1364.
25. Kanagrajan D, Heinsar S, Gandini L, Suen JY, Dau VT, Fraser JF, et al. Preclinical stdies on pulsatile veno-arterial extracorporeal membrane oxygenation: a systematic review. ASAIO J 2023; 69; e167-e180.
26. Kostov K, Blazhev A. Circulating levels of endothelin-1 and big endothelin-1 in patients with essential hypertension. Pathophysiology 2021; 28: 489–495.
27. Ostrow LW, Suchyna TM, Sachs F. Stretch induced endothelin-1 secretion by adult rat astrocytes involves calcium influx via stretch-activated ion channels (SACs). Biochem Biophys Res Commun 2011; 410: 81–86.