1994 Fiscal Year Final Research Report Summary
Total pulmonary liquid instillation under extracorporeal lung assist in dogs
| Project/Area Number |
05454424
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | KUMAMOTO UNIVERSITY |
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Principal Investigator |
TERASAKI Hidenori KUMAMOTO UNIV., ANESTH., PROFESSOR, 医学部, 教授 (30040562)
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| Co-Investigator(Kenkyū-buntansha) |
SIIHARA K KUMAMOTO UNIV., ANESTH., ASSISTANT, 医学部, 助手 (30253735)
SHIBATA Y KUMAMOTO UNIV.HOSP., ANESTH., ASSISTANT, 医学部・付属病院, 教授 (50264304)
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| Project Period (FY) |
1993 – 1994
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| Keywords | Respiratory failure / Extracorporeal lung assist / Extracorporeal circulation / Pulmonary liquid instillation / Pulmonary lavage / Artificial membrane lung / Total bypass / Veno-arterial bypass |
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| Research Abstract |
Extracorporporeal lung and heart assist (ECLHA) , which is prolonged cardiopulmonary bypass with an artifiaial membrane lung, is one of most effective life support means for patients with severe respiratory failure refractory to the conventional therapy. We examined if ECLHA could support the total pulmonary liquid instillation and lavage in anesthetized dogs, to open a new therapeutic modality to wash out wash out inflammatory substances accumulated in the alveolar space of acute respiratory distress syndrome (ARDS). In sixteen dogs (8 to 13 kg of body weight) , a veno-arterial ECLHA provided a bypass blood flow rate of 1,206? B1198 ml/min (mean? B1SD) through the peripheral blood accesses placed into the carotid artey and jugular vein, then we filled the lungs of dogs with the lactate Ringer's solution of 500 to 700 ml under a pressure controlled less than 30 cm H_2O.In a half of the dogs, however, the bypass blood flow rate decreased gradually, hemodynamics deterioreted for a period
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of 24 hours of the lung instillation because in animal study optimal blood transfusion was not available to restore the blood volume. In the remaining 8 animals, ECLHA could sustain the good gas exchange and circulation without particpating in respiration of the normal lungs for 24 hours. Autopsy revealed massive pleural effusion and ascites in all animals that might result from unavoidable hypoproteinemia in no-dlood ECLHA.This study suggested feasibility of the new pulmonary lavage combined with ECLHA,if normal vascular permeability could maintained. Therefore, in the next study we tested effects of prostaglandin (PCE_1) on vascular permeability by measuring the changes in the body weigth of animals undergone ECLHA of 24 hours. We found no singificant difference between the PCE_1 group and control group with regard to body weight, urine output and plasmaprotein. Further studies have to be carried out to establish the pulmonary instillation combined with ECLHA as a new respiratory treatment. Less
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