Aerodynamic evaluation of crystalloid and colloid flush perfusion for lung preservation.
To assess the effectiveness of pulmonary perfusion we evaluated the lung mechanics of 36 canine lungs in an isolated perfused working lung (IPWL) model. Four groups of lungs (n = 9 each) were preserved by pulmonary artery flushing with either high-potassium colloid (UW), high-potassium crystalloid (EuroCollins', EC), low-potassium crystalloid control (lactate), or low-potassium substrate-enhanced crystalloid (RPMI) followed by 130 +/- 10 min of cold storage. Ventilation remained constant (TV 10 ml/kg at 14 breaths/min with 5 cm H2O PEEP). Assessed data included lung resistance (R), timed expiratory volume (EV0.3 sec as %TV), lung compliance (C), elastic work (Wel), and flow-resistive work (Wres). Immediately following storage, R and Wel were similar for all groups (16 +/- 3 cm H2O/liter/sec and 149 +/- 18 gm/min). UW preserved lungs were less compliant (1.5 +/- 0.1 X 10(-2) liter/cm H2O) and required more inspiratory work (Wres 5.8 +/- 0.8 gm/min) compared to the low-potassium crystalloid (Lactate) group (2.0 +/- 0.1 X 10(-2) liter/cm H2O and 3.4 +/- 0.6 gm/min, respectively, P less than 0.05). For 3 hr of reperfusion, crystalloid lungs showed no significant change in R, C, Wel, or Wres. In contrast, R of the UW group increased significantly to 32 +/- 5 and 40 +/- 8 cmH2O/liter/sec at 1 and 3 hr, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
LoCicero
J
J
Northwestern University Medical School, Department of Surgery, Chicago, Illinois 60611-3008.
Massad
M
M
Matano
J
J
Khasho
F
F
Greene
R
R
D000818:Animals; D003102:Colloids; D000077324:Crystalloid Solutions; D004285:Dogs; D005069:Evaluation Studies as Topic; D007552:Isotonic Solutions; D008168:Lung / Q000502:physiology; D008170:Lung Compliance; D010477:Perfusion; D010952:Plasma Substitutes; D011309:Preservation, Biological / Q000379:methods*; D015424:Reperfusion; D012121:Respiration, Artificial
D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes