Lung Physiology During ECS Resuscitation of DCD Donors Followed by In Situ Assessment of Lung Function
| Autor: | Keith E. Cook, Nabeel R. Obeid, Eric Krause, Nathan G. Lafayette, J. D. Punch, Junewai L. Reoma, Robert H. Bartlett, Niru P. Padiyar, Alvaro Rojas, Joshua R. Pohlmann |
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| Rok vydání: | 2009 |
| Předmět: |
Extracorporeal Circulation
medicine.medical_specialty Resuscitation Time Factors Tissue and Organ Procurement Swine Heart Ventricles Biomedical Engineering Biophysics Bioengineering Pulmonary Artery Lung injury FOS: Medical engineering Article Biomaterials Internal medicine medicine.artery medicine Animals Lung Aorta business.industry Extracorporeal circulation 90399 Biomedical Engineering not elsewhere classified Lung Injury Organ Preservation General Medicine Tissue Donors Respiratory Function Tests Death Oxygen Transplantation medicine.anatomical_structure Ventricle Pulmonary artery Cardiology business |
| Zdroj: | ASAIO Journal. 55:388-394 |
| ISSN: | 1058-2916 |
| Popis: | Extracorporeal cardiopulmonary support (ECS) of donors after cardiac death (DCD) has been shown to improve abdominal organs for transplantation. This study assesses whether pulmonary congestion occurs during ECS with the heart arrested and describes an in vivo method to assess if lungs are suitable for transplantation from DCD donors after ECS resuscitation. Cardiac arrest was induced in 30 kg pigs, followed by 10 min of warm ischemia. Cannulae were placed into the right atrium (RA) and iliac artery, and veno-arterial ECS was initiated for 90 min with lungs inflated, group 1 (n = 5) or deflated, group 2 (n = 3). Left atrial pressures were measured as a marker for pulmonary congestion. After 90 min of ECS, lung function was evaluated. Cannulae were placed into the pulmonary artery (PA) and left ventricle (LV). A second pump was included, and ECS was converted to a bi-ventricular (bi-VAD) system. The RVAD drained from the RA and pumped into the PA, and the LVAD drained the LV and pumped into the iliac. This brought the lungs back into circulation for a 1-hr assessment period. The oxygenator was turned off, and ventilation was restarted. Flows, blood gases, PA and left atrial pressures, and compliance were recorded. In both the groups, LA pressure was15 mm Hg during ECS. During the lung assessment period, PA flows were 1.4-2.2 L/min. PO2 was300 mm Hg, with normal PCO2. Extracorporeal cardiopulmonary support resuscitation of DCD donors is feasible and allows for assessment of function before procurement. Extracorporeal cardiopulmonary support does not cause pulmonary congestion, and the lungs retain adequate function for transplantation. Compliance correlated with lung function. |
| Databáze: | OpenAIRE |
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