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

    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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