溶解氧在有毒外体膜氧化支持过程中对系统氧化有显著的贡献
Michael C Müller1, Sarah K Wilke, Andrej Dobbermann
1From the Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.
概括
溶解氧显著影响有毒外体膜氧化 (VV ECMO) 患者的氧气转移. 这种物理溶解的氧气分数对于管理VV ECMO设置和断奶程序至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 心肺生理学 心肺生理学
- 生物医学工程 生物医学工程
背景情况:
- 静脉外体膜氧化 (VV ECMO) 是严重呼吸衰竭的生命支持疗法.
- 由于溶解氧的溶解性较低,在VV ECMO期间溶解氧对氧转移的贡献往往被低估.
研究的目的:
- 量化溶解氧对急性呼吸困扰综合征 (ARDS) 患者系统氧化的影响.
- 在VV ECMO过程中区分溶解氧和血红蛋白结合氧的转移.
主要方法:
- 通过血液气体分析和MEEP协议计算体外氧气转移 (VML O2).
- 通过间接热量计来测量本源肺氧吸收量 (VO2总量).
- 从血红蛋白结合的氧气转移中分化溶解的氧气.
主要成果:
- 溶解氧占VML O2的20%以上,占VO2总量的10%以上.
- 溶解氧的转移主要取决于ECMO血流 (BF ML).
- 在严重的ARDS中,溶解的氧气占总氧气吸收量的28%.
结论:
- 在VV ECMO过程中,临床上显著的氧气被转移为物理溶解分数.
- 在评估膜肺功能和管理VV ECMO设置时,必须考虑溶解氧.
- 准确评估溶解氧气对于指导VV ECMO断奶程序至关重要.
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