title: Oxygenation effect of interventional lung assist in a lavage model of acute lung injury: a prospective experimental study.
abstract: BACKGROUND
  The aim of the study was to test the hypothesis that a pumpless arteriovenous extracorporeal membrane oxygenator (interventional lung assist (ILA)) does not significantly improve oxygenation in a lavage model of acute lung injury.
  
  
  METHODS
  The study was designed as a prospective experimental study. The experiments were performed on seven pigs (48-60 kg body weight). The pigs were anesthetized and mechanically ventilated. Both femoral arteries and one femoral vein were cannulated and connected with ILA. Acute lung injury was induced by repeated bronchoalveolar lavage until the arterial partial pressure of O2 was lower than 100 Torr for at least 30 minutes during ventilation with 100% O2.
  
  
  RESULTS
  ILA was applied with different blood flow rates through either one or both femoral arteries. Measurements were repeated at different degrees of pulmonary gas exchange impairment with the pulmonary venous admixture ranging from 35.0% to 70.6%. The mean (+/- standard deviation) blood flow through ILA was 15.5 (+/- 3.9)% and 21.7 (+/- 4.9)% of cardiac output with one and both arteries open, respectively. ILA significantly increased the arterial partial pressure of O2 from 64 (+/- 13) Torr to 71 (+/- 14) Torr and 74 (+/- 17) Torr with blood flow through one and both femoral arteries, respectively. O2 delivery through ILA increased with extracorporeal shunt flow (36 (+/- 14) ml O2/min versus 47 (+/- 17) ml O2/min) and reduced arterialization of the inlet blood. Pulmonary artery pressures were significantly reduced when ILA was in operation.
  
  
  CONCLUSIONS
  Oxygenation is increased by ILA in severe lung injury. This effect is significant but small. The results indicate that the ILA use may not be justified if the improvement of oxygenation is the primary therapy goal.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany. zick@anaesthesie.uni-kiel.de
authors.forename: Günther
authors.initials: G
authors.lastname: Zick
authors.forename: Inéz
authors.initials: I
authors.lastname: Frerichs
authors.forename: Dirk
authors.initials: D
authors.lastname: Schädler
authors.forename: Gunnar
authors.initials: G
authors.lastname: Schmitz
authors.forename: Sven
authors.initials: S
authors.lastname: Pulletz
authors.forename: Erol
authors.initials: E
authors.lastname: Cavus
authors.forename: Felix
authors.initials: F
authors.lastname: Wachtler
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Norbert
authors.initials: N
authors.lastname: Weiler
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis / Q000379:methods; D018893:Bronchoalveolar Lavage / Q000379:methods*; D004195:Disease Models, Animal; D010100:Oxygen / Q000502:physiology*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D013552:Swine
chemical_list: D010100:Oxygen