Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation

Area of Science:

• Physiology
• Medical Devices
• Biomedical Engineering

Background:

• Hypoxia remains a significant cause of mortality in patients with reversible pulmonary failure, even with maximal ventilatory support.
• Current supportive care measures for hypoxia often require systemic anticoagulation, posing additional risks.
• There is a critical need for alternative methods to enhance oxygenation without systemic anticoagulation.

Purpose of the Study:

• To investigate the potential of using the peritoneal cavity for gas exchange.
• To determine if perfusing the abdominal cavity with oxygenated perfluorocarbons can increase systemic oxygenation in a large animal model of induced hypoxia.

Main Methods:

• Fifteen pigs (45 +/- 5 kg) were intubated and subjected to induced hypoxia (inspired oxygen from 18% to 10%).
• Eight animals underwent peritoneal perfusion with oxygenated perfluorocarbon, while seven control animals received oxygenated saline solution.
• Arterial blood gases, including partial pressure of oxygen (Pao(2)), were monitored throughout the experiment.

Main Results:

• Perfusion with oxygenated perfluorocarbon resulted in an average increase in Pao(2) of 12.8 mm Hg compared to oxygenated saline.
• At an inspired oxygen fraction of 14%, Pao(2) increased from 39.4 mm Hg (saline) to 55.3 mm Hg (perfluorocarbon).
• This Pao(2) increase corresponded to a rise in arterial oxygen saturation from 73% to 89%.

Conclusions:

• The peritoneal cavity can serve as a site for gas exchange, effectively increasing systemic oxygen levels.
• Peritoneal perfusion with oxygenated perfluorocarbons offers a potential new modality for supportive care in patients with severe, reversible hypoxia.
• This technique may provide a viable alternative to conventional therapies, particularly in cases where anticoagulation is contraindicated.