| Effect of Extracorporeal Membrane Oxygenation during Diffuse Alveolar Hypoxia on Oxygen Transport . |
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Seong Deok Kim |
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Department of Anesthesiology, College of Medicine, Seoul National University, Seoul 110-744, Korea. |
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| Abstract |
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To evaluate the effect of extracarporeal membrane oxygenation(ECMO) during diffuse alveolar hypoxia on oxyen transport(O2 flux), we made experimental model similar to pathologic conditions of acute respiratory failure(ARF) and adult respiratory distress syndrome(ARDS) by stepwise reduction of fraction of inspired oxygen(F1O2)from 0.21 to 0.15 and finally 0.10. This stepwise reduction of F1O2 caused no significant changes in cardiac output(CO), O 2 flux and oxygen consumption(VO2), but it resulted in increases of oxygen extraction ratio(O2ER) and AaDO2 only in F1O2 0,10, and Q(s)/Q(T) in F1O2 0.15 and 0.10.
Venovenous(VV) ECMO increased O flux only at F1O2 0.10, and decreased VO2 remarkably in each F1O2, which resulted in decrease of O2 ER in each F1O2. AaDO2 was decreased in every situations, but pulmonary shunt ratio(Qs/Qt) showed significant decrease only in F1O2 0.15. We can conclude that VV ECMO might improve tissue oxygenation by increase of O flux and decrease of VO2AaDO2 and Qs/Qt in moderate and severe alveolar hypoxia, and might be clinically useful for the treatment of severe ARF and ARDS. Moreover, VV ECMO may be a useful method for the basic research in the pulmonary pathophysiology. |
| Key Words:
ECMO; Diffuse alveolar hypoxia; O flux; Dog |
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