Comparison of A-V and V-V bypass ECMO-With a focus of pulmonary hyperfine structural changes

• Published in: Jinko Zoki Vol. 23; no. 5; pp. 1095 - 1101
• Main Author: HORIKOSI, M
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR ARTIFICIAL ORGANS 1994
• Subjects: ECMO A-V bypass; ultrastructure of the lung; V-V bypass
• ISSN: 0300-0818; 1883-6097
• DOI: 10.11392/jsao1972.23.1095

Pumpless AV ECMO (AV group, n=9) and centrifugation pump-driven VV ECMO (VV group, n=12) were compared in gas exchanging capacity, blood injury and pulmorary hyperfine structural changes in a model of hypoventilation acute respiratory failure using adult mongrel dogs. Dogs of a non-ECMO group (n=5) were separately prepared as controls. The gas exchanging capacity and blood injury were not significantly different between the AV and VV groups. In the hyperfine structure of the lung, blood-air barrier and interstitial edematous changes were severer in the AV group than in the VV. Edematous change was semiquantified by measuring the thickness of basement membrane by the pointcount method. The value was significantly higher in the AV group than in the VV. Compared to the two ECMO groups, considerably sever edematous and destructive changes were noted in the control dogs with a significantly greater thickness of basement membrane. As another laboratory experiment of hemodynamics, change in AP, PAP and CO were compared between the AV(n=6) and VV(n=6) ECMO groups. In the AV group significant increases in CO and PAP were observed in association with an increase in volume. In the VV group on the other hand there was no such change occurring. These results suggest that for ECMO treatment of alveolar hypoventilation type of respiratory failure the VV bypass method should be superior to the AV one in terms of hemodynamic and hyperfine structure of the lung.