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Perfusion, Vol. 21, No. 5, 277-284 (2006)
DOI: 10.1177/0267659106074769

The contribution of arterio-venous extracorporeal lung assist to gas exchange in a porcine model of lavage-induced acute lung injury

Jörg Brederlau

Ralf Muellenbach

Markus Kredel

Ulrich Schwemmer

Martin Anetseder

Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany

Clemens Greim

Department of Anaesthesiology, Fulda Hospital, Fulda, Germany

Norbert Roewer

Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany

This prospective large-animal study was performed to evaluate the contribution of arterio-venous extracorporeal lung assist (AV-ECLA) to pulmonary gas exchange in a porcine lavage-induced acute lung injury model. Fifteen healthy female pigs, weighing 50.39±3.8 kg (mean±SD), were included.

After induction of general anaesthesia and controlled ventilation, an arterial line and a pulmonary artery catheter were inserted. Saline lung lavage was performed until the PaO2 decreased to 51±16 mmHg. After a stabilization period of 60 min, the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed. Under apnoeic oxygenation, variations of sweep-gas flow were performed every 20 min in order to evaluate the membrane lung's efficacy, in terms of carbon dioxide (CO2) removal and oxygen (O2) uptake. Although AV-ECLA is highly effective in eliminating CO2, if combined with apnoeic oxygenation, normocapnia was not achievable. AV-ECLA's contribution to oxygenation during severe hypoxemia was antagonized by a significant increase in the pulmonary shunt fraction.


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