Stable Mixed Acidemia in Anesthetized Pigs—A Model for Research on Biocompatibility of Hemofilters Under a Deteriorated Acid-Base Balance

摘要

In recent years, acidosis has been of growing interest in intensive care medicine. Most animal models only provide a short-term investigation of the effects of acidosis. They are not suitable for research on interactions with extracorporeal organ support (here continuous venovenous hemofiltration, CVVH). The rationale for this study was to establish a porcine model of prolonged mixed acidemia, which is suitable for research on the interactions of acidemia and CVVH. After the induction of anesthesia in pigs (40?kg), acidemia was induced and maintained in one group with a bolus of 0.4?mol/L lactic acid followed by continuous infusion and a reduced respiratory frequency (lactic acid-group, n?=?4). In another group, mixed acidemia was induced with a 0.4?mol/L acid solution (lactic and hydrochloric acid) and low tidal volume ventilation (mixed acidemia-group, n?=?8). To get first proof of the model's suitability to operate over an extracorporeal circuit, CVVH was additionally performed in seven pigs (mixed acidemia/CVVH-group, n?=?7). The target for the pH was 7.19–7.24. The targeted pH was constantly missed in the lactic acid group, whereas it was successfully maintained for 3.5?h in four out of eight pigs of the mixed acidemia group, and in five out of seven pigs of the mixed acidemia/CVVH group. The CVVH was performed successfully for 3?h in all pigs of the respective group. The mixed acidemia model was sufficient to maintain a low pH within a narrow range for some hours and enabled research on hemofilters in vivo.