Comparison of the effect of membrane sizes and fibre arrangements of two membrane oxygenators on the inflammatory response, oxygenation and decarboxylation in a rat model of extracorporeal membrane oxygenation

摘要

Extracorporeal membrane oxygenation (ECMO) has gained widespread acceptance for the treatment of critically ill patients suffering from cardiac and/or respiratory failure. Various animal models have been developed to investigate the adverse effects induced by ECMO. Different membrane oxygenators have been used with varying priming volumes and membrane surfaces (Micro-1, small animal membrane oxygenator (SAMO)). Sixteen male Lewis rats (350–400?g) were randomly assigned to receive ECMO with Micro-1 or SAMO (n?=?8, respectively). Venoarterial ECMO was established after cannulation of the femoral artery and the jugular vein. The cardiac output was measured using a left-ventricular conductance catheter. The oxygen fraction of the ECMO was set to 1.0, 0.75, 0.5 and 0.21 after a stabilisation period of 15?min. Further, arterial blood gas analyses were performed at baseline, and during the first hour every 15?min after commencing the ECMO, and subsequently every 30?min. Dilutional anaemia was calculated using haemoglobin concentration at baseline, and 15?min after the start of ECMO therapy. Moreover, inflammation was determined by measuring tumour necrosis factor alpha, interleukin-6 and -10 at baseline and every 30?min. Animals of the Micro-1 group showed a significantly lower dilutional anaemia (ΔHaemoglobin t0 – t0.25: SAMO 6.3 [5.6–7.5] g/dl vs. Micro-1 5.6 [4.6–5.8] g/dl; p?=?0.028). Further, significantly higher oxygen partial pressure was measured in the SAMO group, at an oxygen fraction of 0.75, 0.5 and 0.21 (380 [356–388] vs. 314 [263–352] mmHg, p?=?0.002; 267 [249–273] mmHg vs. 197 [140–222] mmHg, p?=?0.002; 87 [82–106] mmHg vs. 76 [60–79] mmHg, p?=?0.021, respectively). However, no differences were found regarding the oxygen fraction of 1.0, in terms of carbon-dioxide partial pressure and cardiac output. Moreover, in the Micro-1 group tumour necrosis factor alpha was increased after 60?min and interleukin-6 after 120?min. While the dilutional anaemia was increased after commencing the ECMO, the oxygenation was augmented in the SAMO group. The inflammatory response was elevated in the Micro-1 group.