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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.58 (2012) >

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タイトル: The endocrinological responses of veno-venous extracorporeal membrane oxygenation on hypoxic fetal lambs
その他のタイトル: The endocrinological responses of V-V ECMO on hypoxic fetal lambs
著者: Nomura, Yasuhisa
Kato, Katsuhiko
Fujimori, Keiya
Shiroto, Tomohiro
Ishida, Tomohiko
Sato, Akira
学内所属: 産科婦人科学講座
誌名/書名: Fukushima Journal of Medical Science
巻: 58
号: 1
開始ページ: 9
終了ページ: 16
発行日: 2012年
抄録: Objective: The purpose of this study was to observe endocrinological responses of veno-arterial and veno-venous extracorporeal membrane oxygenation (V-A and V-V ECMO) to support fetal oxygenation in utero. Methods: An ECMO system with a centrifugal pump was applied to six chronically instrumented fetal lambs, at 126-134 days of gestation. Blood was obtained through a double-lumen catheter inserted into the right atrium. After oxygenation, the blood was returned through a single-lumen catheter into either the carotid artery (veno-arterial; V-A ECMO) or the right atrium (V-V ECMO). After fetal hypoxia had been experimentally produced, V-A ECMO or V-V ECMO was instituted to maintain fetal oxygenation. We compared fetal blood gases and concentrations of atrial natriuretic peptide (ANP), epinephrine and norepinephrine with both routes of ECMO. Results: Fetal carotid artery pH did not change during hypoxemia, but decreased after instituting V-A ECMO and V-V ECMO. After instituting V-A ECMO or V-V ECMO for 30 min, oxygen partial pressure (pO2) in the fetal cranial carotid artery recovered from the hypoxic level. The ANP concentration in V-V ECMO was significantly lower than that in V-A ECMO. Fetal serum epinephrine and norepinephrine concentrations significantly increased in association with hypoxic stimulation. There was a further increase in fetal serum epinephrine concentration after instituting V-A ECMO. No significant difference in concentration was found after instituting V-V ECMO from that of after the institution of V-A ECMO. Conclusions: This study suggested that V-V ECMO may possibly be less invasive than V-A ECMO for fetal heart, because ANP, a cardiac distress index, was lower in V-V ECMO than in V-A ECMO.
出版者: The Fukushima Society of Medical Science
出版者(異表記): 福島医学会
本文の言語: eng
このページのURI: http://ir.fmu.ac.jp/dspace/handle/123456789/318
本文URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/318/1/FksmJMedSci_58_p9.pdf
ISSN: 0016-2590
2185-4610
DOI: 10.5387/fms.58.9
PubMed番号: 22790887
異版(出版者版等): http://dx.doi.org/10.5387/fms.58.9
権利情報: © 2012 The Fukushima Society of Medical Science
出現コレクション:Vol.58 (2012)

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