title: The contribution of arterio-venous extracorporeal lung assist to gas exchange in a porcine model of lavage-induced acute lung injury.
abstract: This prospective large-animal study was performed to evaluate the contribution of arterio-venous extracorporeal lung assist (AV-ECLA) to pulmonary gas exchange in a porcine lavage-induced acute lung injury model. Fifteen healthy female pigs, weighing 50.3 +/- 3.8 kg (mean +/- SD), were included. After induction of general anaesthesia and controlled ventilation, an arterial line and a pulmonary artery catheter were inserted. Saline lung lavage was performed until the PaO2 decreased to 51 +/- 16 mmHg. After a stabilization period of 60 min, the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed. Under apnoeic oxygenation, variations of sweep-gas flow were performed every 20 min in order to evaluate the membrane lung's efficacy, in terms of carbon dioxide (CO2) removal and oxygen (O2) uptake. Although AV-ECLA is highly effective in eliminating CO2, if combined with apnoeic oxygenation, normocapnia was not achievable. AV-ECLA's contribution to oxygenation during severe hypoxemia was antagonized by a significant increase in the pulmonary shunt fraction.
authors.affiliation: Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany. brederlau_j@klinik.uni-wuerzburg.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Brederlau
authors.forename: Ralf
authors.initials: R
authors.lastname: Muellenbach
authors.forename: Markus
authors.initials: M
authors.lastname: Kredel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schwemmer
authors.forename: Martin
authors.initials: M
authors.lastname: Anetseder
authors.forename: Clemens
authors.initials: C
authors.lastname: Greim
authors.forename: Norbert
authors.initials: N
authors.lastname: Roewer
mesh_terms: D000818:Animals; D018893:Bronchoalveolar Lavage / Q000009:adverse effects*; D002245:Carbon Dioxide / Q000097:blood; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D023421:Models, Animal; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*; D012212:Rheology; D034421:Sus scrofa
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen