Development of a Model of Pediatric Lung Failure Pathophysiology.
A pediatric artificial lung (PAL) is under development as a bridge to transplantation or lung remodeling for children with end-stage lung failure (ESLF). To evaluate the efficiency of a PAL, a disease model mimicking the physiologic derangements of pediatric ESLF is needed. Our previous right pulmonary artery (rPA) ligation model (rPA-LM) achieved that goal, but caused immediate mortality in nearly half of the animals. In this study, we evaluated a new technique of gradual postoperative right pulmonary artery occlusion using a Rummel tourniquet (rPA-RT) in seven (25-40 kg) sheep. This technique created a stable model of ESLF pathophysiology, characterized by high alveolar dead space (58.0% ± 3.8%), pulmonary hypertension (38.4 ± 2.2 mm Hg), tachypnea (79 ± 20 breaths per minute), and intermittent supplemental oxygen requirement. This improvement to our technique provides the necessary physiologic derangements for testing a PAL, whereas avoiding the problem of high immediate perioperative mortality.
From the *Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan; †Department of Surgery, Columbia University Medical Center, New York, New York; ‡Department of Surgery, Universidad el Bosque - Escuela Colombiana de Medicina, Bogota, Colombia; §Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; ¶Department of Surgery, Section of Transplant Surgery, University of Michigan Health Systems, Ann Arbor, Michigan; and ‖Department of Surgery, Section of Pediatric Surgery, University of Michigan Health Systems, Ann Arbor, Michigan.
John M
JM
Trahanas
Fares
F
Alghanem
Catalina
C
Ceballos-Muriel
Hayley R
HR
Hoffman
Alice
A
Xu
Kristopher B
KB
Deatrick
Marie S
MS
Cornell
Alvaro
A
Rojas-Pena
Robert H
RH
Bartlett
Ronald B
RB
Hirschl
D000818:Animals; D001187:Artificial Organs; D002648:Child; D004195:Disease Models, Animal; D006801:Humans; D008026:Ligation; D008168:Lung; D012131:Respiratory Insufficiency / Q000628:therapy*; D012756:Sheep