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Total and prolonged filling of the lungs with Ringer’s solution under extracorporeal lung assist (ECLA) in dogs
Author(s) -
Sakanashi Y.,
Tanimoto H.,
Okamoto T.,
Tashiro M.,
Ao H.,
Terasaki H.
Publication year - 2000
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2000.440817.x
Subject(s) - medicine , anesthesia , lung , mechanical ventilation , extracorporeal , ventilation (architecture) , artificial lung , peak inspiratory pressure , ringer's solution , saline , artificial ventilation , tracheal tube , airway , surgery , respiratory system , tidal volume , respiratory disease , anatomy , mechanical engineering , engineering
Background: Massive alveolar lavage has been used clinically to remove materials accumulated in the alveoli. Recently, filling the lungs with oxygenated perfluorochemical (total liquid ventilation) has been investigated. However, effects of complete and prolonged filling of bilateral lungs with aqueous fluid, such as saline or Ringer’s solution, has not been evaluated, although it is possible to sustain gas exchange without the natural lung by using extracorporeal circulation and an artificial lung (extracorporeal lung assist: ECLA). It is also not known whether the lung can recover gas exchange ability after prolonged fluid filling. Methods: Normal mongrel dogs were endotracheally intubated under general anesthesia and mechanically ventilated. After initiation of venoarterial ECLA, warmed lactated Ringer’s solution was instilled into the lungs through the endotracheal tube, and the lungs were completely filled at a hydrostatic pressure of 15 cmH 2 O (fluid‐filled group: group F). After the lungs were filled for 4 h, the fluid was drained and ventilation was re‐instituted. ECLA, then mechanical ventilation was gradually weaned within 24 h after fluid drainage. In control group (group C), dogs were kept apneic for 4 h with their lungs inflated at an airway pressure of 15 cmH 2 O with air. Results: Transient hypoxemia occurred during fluid filling but every dog could be weaned from ECLA and mechanical ventilation to spontaneous respiration. The average rate of fluid absorption from the lung during fluid filling was 4.2±1.8 ml kg −1 h −1 . After fluid drainage and restart of mechanical ventilation, bilateral lungs were expanded and well aerated. Total static respiratory system compliance (static compliance) remained unchanged even after fluid filling, and the weight of the lung water did not increase significantly compared to that in group C. Total urine volume was significantly increased in group F. Histologically, alveolar structures were preserved and no interstitial edema or bleeding was seen in either group. Conclusion: Complete filling of the bilateral lungs for 4 h with lactated Ringer’s solution under ECLA causes no deterioration in gas exchange or static compliance in normal dogs, although transient hypoxemia occurs during fluid filling.