| Japanese |
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| Title | 人工肺併用左心バイパスが胸部下行大動脈遮断時の血行動態および酸素化能に及ぼす影響 |
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| Subtitle | 原著 |
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| Authors | 小高桂子, 野村実, 加藤真弓, 長沢千奈美, 近藤泉, 三浦芳則, 鈴木英弘 |
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| Organization | 東京女子医科大学麻酔科学教室 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 4 |
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| Page | 560-565 |
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| Year/Month | 1996/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」胸部下行大動脈瘤手術時には, 右一側肺換気(DLV)による低酸素血症が問題となる. そこで, 雑種イヌで左心バイパス回路に膜型人工肺を組み込み, DLV下での左心バイパスモデルを作製し, 酸素化能および血行動態にどのように影響をもたらすかを検討した. 左心バイパスは, 下行大動脈遮断によって生じた左室拡張終期圧の上昇を遮断前値まで低下させ, 良好な血行動態を維持することが可能であった. また, 膜型人工肺の併用は, DLVにより低下した動脈血酸素分圧を, 有意に上昇させた. 以上から, 膜型人工肺併用左心バイパスは, 胸部下行大動脈遮断時のDLV中の酸素化能の改善および血行動態維持に有用であった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Left heart bypass, Membranous oxygenator, Differential lung ventilation |
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| English |
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| Title | Chsnges of Hemodymamics and Oxygemation during Thoracic Aortic Clamping using Left Heart Bypass with Membranous Oxygemator |
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| Authors | Keiko Kodaka, Minoru Nomura, Mayumi Kato, Tinami Nagasawa, Izumi Kondo, Yoshinori Miura, Hidehiro Suzuki |
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| Organization | Department of Anesthesiolosy, Tokyo Women's Medical College |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 4 |
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| Page | 560-565 |
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| Year/Month | 1996/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Hypoxemia due to bleeding with differential lung ventilation (DLV) is one of the most serious complications during thoracic aortic surgery with left heart bypass (LHB). In this report, we use a new system, which contains a centrifugal pump and a membranous oxygenator, and report its usefulness during thoracie aortic surgery. Eight mongrel dogs were anesthetized, intubated an endotrachial tube with a movable blocker, which directed to the left main bronchus. The left anterior descending coronary artery was stenosed to 50 %, following hypoxemia due to DLV and the descending thoracic aorta was cross-clamped, we started left atrio-left femoral artery bypass with 30 ml/kg flow. And then, LHB flow was increased to 50, 70 ml/kg with each 30 min. In our study, LHB with the membranous oxygenator significantly increased systemic arterial oxygen pressure compared with DLV. The increase of arterial oxygen pressure was partly explained from the shunt flow through the descending aorta flow by the membranous oxygenator. Application of the left heart bypass decreased LVEDP to pre-clamping values. We conclude that our new method, LHB with the membranous oxygenator, is useful during thoracic aortic surgery. (Circ Cont 17：560〜565, 1996) |
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| Practice | Basic medicine |
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| Keywords | Left heart bypass, Membranous oxygenator, Differential lung ventilation |
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