title: Can a membrane oxygenator be a model for lung NO and CO transfer?
abstract: To model lung nitric oxide (NO) and carbon monoxide (CO) uptake, a membrane oxygenator circuit was primed with horse blood flowing at 2.5 l/min. Its gas channel was ventilated with 5 parts/million NO, 0.02% CO, and 22% O2 at 5 l/min. NO diffusing capacity (Dno) and CO diffusing capacity (Dco) were calculated from inlet and outlet gas concentrations and flow rates: Dno = 13.45 ml.min(-1).Torr(-1) (SD 5.84) and Dco = 1.22 ml.min(-1).Torr(-1) (SD 0.3). Dno and Dco increased (P = 0.002) with blood volume/surface area. 1/Dno (P < 0.001) and 1/Dco (P < 0.001) increased with 1/Hb. Dno (P = 0.01) and Dco (P = 0.004) fell with increasing gas flow. Dno but not Dco increased with hemolysis (P = 0.001), indicating Dno dependence on red cell diffusive resistance. The posthemolysis value for membrane diffusing capacity = 41 ml.min(-1).Torr(-1) is the true membrane diffusing capacity of the system. No change in Dno or Dco occurred with changing blood flow rate. 1/Dco increased (P = 0.009) with increasing Po2. Dno and Dco appear to be diffusion limited, and Dco reaction limited. In this apparatus, the red cell and plasma offer a significant barrier to NO but not CO diffusion. Applying the Roughton-Forster model yields similar specific transfer conductance of blood per milliliter for NO and CO to previous estimates. This approach allows alteration of membrane area/blood volume, blood flow, gas flow, oxygen tension, red cell integrity, and hematocrit (over a larger range than encountered clinically), while keeping other variables constant. Although structurally very different, it offers a functional model of lung NO and CO transfer.
authors.affiliation: Department of Medicine, Hinchingbrooke Hospital, Huntingdon, Cambridgeshire PE18 8NT, United Kingdom. colin.borland@hinchingbrooke.nhs.uk
authors.forename: Colin
authors.initials: C
authors.lastname: Borland
authors.forename: Helen
authors.initials: H
authors.lastname: Dunningham
authors.forename: Fiona
authors.initials: F
authors.lastname: Bottrill
authors.forename: Alain
authors.initials: A
authors.lastname: Vuylsteke
mesh_terms: D000818:Animals; D001692:Biological Transport / Q000502:physiology; D002248:Carbon Monoxide / Q000378:metabolism*; D004058:Diffusion; D004910:Erythrocyte Membrane / Q000502:physiology; D006400:Hematocrit; D006736:Horses; D008168:Lung / Q000098:blood supply / Q000502:physiology*; D008954:Models, Biological; D009569:Nitric Oxide / Q000378:metabolism*; D010100:Oxygen / Q000493:pharmacokinetics; D010107:Oxygenators, Membrane; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012039:Regional Blood Flow
chemical_list: D009569:Nitric Oxide; D002248:Carbon Monoxide; D010100:Oxygen