Paracorporeal artificial lung

Perioperative management for survival study in sheep

Scott D Lick, Donald J. Deyo, Dongfang Wang, Sarah A. Witt, Scott K. Alpard, Donald D. Harper, Joseph B. Zwischenberger

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

An artificial lung may offer a bridge to recovery or transplant. Utilizing our recently developed paracorporeal artificial lung (PAL) in survival studies in sheep, we critically review our perioperative/anesthetic protocol. Adult Suffolk ewes (n = 15) underwent general anesthesia induced by ketamine (7-15 mg/kg, im) and isoflurane by mask, then intubated and maintained by 4.0-5.0% isoflurane titrated to mean arterial pressure (MAP) 70-110 mm Hg. After a latissimus-sparing thoracotomy and systemic heparinization (200 IU/kg), arterial grafts were anastomosed to the proximal and distal main pulmonary artery in an end-of-graft to side-of-artery fashion. A snare was passed around the pulmonary artery between anastomoses. When the snare was tightened, full pulmonary blood flow was diverted through the cannulae and immediately through the PAL. Perioperative crystalloids included a 500-mL prime, lactated Ringer's (LR) titrated to CVP 5-7 mm Hg, and a heparin infusion (activated clotting time [ACT] 250-300 s). Buprenorphine (0.3 mg im tid) controlled postoperative pain. Hemodynamic parameters, arterial blood gases (ABGs), and ACTs were measured every 6 h. Thirteen of 15 sheep survived the operation and were extubated in less than 20 min. Two groups were studied for up to 7-day survival. Both groups underwent immediate connection to the PAL diverting full pulmonary blood flow. Group 1 (n = 8) underwent immediate connection to a rigidly housed PAL, and 4 of 8 demonstrated immediate right heart failure. In Group 2 a compliance chamber was added to the PAL inflow, and 6 of 7 had stable hemodynamic function for the duration of the study. Incremental improvements in the PAL and our anesthetic and perioperative care have resulted in reliable survival in adult sheep allowing for artificial lung development.

Original languageEnglish (US)
Pages (from-to)177-184
Number of pages8
JournalJournal of Investigative Surgery
Volume16
Issue number3
StatePublished - May 2003
Externally publishedYes

Fingerprint

Sheep
Lung
Isoflurane
Transplants
Pulmonary Artery
Anesthetics
Hemodynamics
Perioperative Care
Buprenorphine
Ketamine
Thoracotomy
Postoperative Pain
Masks
General Anesthesia
Compliance
Heparin
Arterial Pressure
Heart Failure
Arteries
Gases

Keywords

  • Anesthesia
  • Animal model
  • ARDS
  • Artificial lung
  • Artificial organs
  • Extracorporeal

ASJC Scopus subject areas

  • Surgery

Cite this

Lick, S. D., Deyo, D. J., Wang, D., Witt, S. A., Alpard, S. K., Harper, D. D., & Zwischenberger, J. B. (2003). Paracorporeal artificial lung: Perioperative management for survival study in sheep. Journal of Investigative Surgery, 16(3), 177-184.

Paracorporeal artificial lung : Perioperative management for survival study in sheep. / Lick, Scott D; Deyo, Donald J.; Wang, Dongfang; Witt, Sarah A.; Alpard, Scott K.; Harper, Donald D.; Zwischenberger, Joseph B.

In: Journal of Investigative Surgery, Vol. 16, No. 3, 05.2003, p. 177-184.

Research output: Contribution to journalArticle

Lick, SD, Deyo, DJ, Wang, D, Witt, SA, Alpard, SK, Harper, DD & Zwischenberger, JB 2003, 'Paracorporeal artificial lung: Perioperative management for survival study in sheep', Journal of Investigative Surgery, vol. 16, no. 3, pp. 177-184.
Lick SD, Deyo DJ, Wang D, Witt SA, Alpard SK, Harper DD et al. Paracorporeal artificial lung: Perioperative management for survival study in sheep. Journal of Investigative Surgery. 2003 May;16(3):177-184.
Lick, Scott D ; Deyo, Donald J. ; Wang, Dongfang ; Witt, Sarah A. ; Alpard, Scott K. ; Harper, Donald D. ; Zwischenberger, Joseph B. / Paracorporeal artificial lung : Perioperative management for survival study in sheep. In: Journal of Investigative Surgery. 2003 ; Vol. 16, No. 3. pp. 177-184.
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