Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome

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dc.contributor.authorAraos, Joaquín
dc.contributor.authorAlegría, Leyla
dc.contributor.authorGarcía, Patricio
dc.contributor.authorDamiani, Felipe
dc.contributor.authorTapia, Pablo
dc.contributor.authorSoto, Dagoberto
dc.contributor.authorSalomón, Tatiana
dc.contributor.authorRodríguez, Felipe
dc.contributor.authorAmthauer, Macarena
dc.contributor.authorErranz, Benjamín
dc.contributor.authorCastro, Gabriel
dc.contributor.authorCarreño, Pamela
dc.contributor.authorMedina, Tania
dc.contributor.authorRetamal, Jaime
dc.contributor.authorCruces, Pablo
dc.contributor.authorBugedo, Guillermo
dc.contributor.authorBruhn, Alejandro
dc.date.accessioned2017-01-04T15:28:15Z
dc.date.available2017-01-04T15:28:15Z
dc.date.issued2016
dc.descriptionCentro de Medicina Regenerativa
dc.description.abstractExtracorporeal membrane oxygenation (ECMO) is increasingly being used to treat severe acute respiratory distress syndrome (ARDS). However, there is limited clinical evidence about how to optimize the technique. Experimental research can provide an alternative to fill the actual knowledge gap. The purpose of the present study was to develop and validate an animal model of acute lung injury (ALI) which resembled severe ARDS, and which could be successfully supported with ECMO. Eighteen pigs were randomly allocated into three groups: sham, ALI, and ALI + ECMO. ALI was induced by a double-hit consisting in repeated saline lavage followed by a 2-hour period of injurious ventilation. All animals were followed up to 24 hours while being ventilated with conventional ventilation (tidal volume 10 ml/kg). The lung injury model resulted in severe hypoxemia, increased airway pressures, pulmonary hypertension, and altered alveolar membrane barrier function, as indicated by an increased protein concentration in bronchoalveolar fluid, and increased wet/dry lung weight ratio. Histologic examination revealed severe diffuse alveolar damage, characteristic of ARDS. Veno-venous ECMO was started at the end of lung injury induction with a flow > 60 ml/kg/min resulting in rapid reversal of hypoxemia and pulmonary hypertension. Mortality was 0, 66.6 and 16.6% in the SHAM, ALI and ALI + ECMO groups, respectively (p < 0.05). This is a novel clinically relevant animal model that can be used to optimize the approach to ECMO and foster translational research in extracorporeal lung support.
dc.identifier.citationAraos J, Alegría L, García P, Damiani F, Tapia P, Soto D, Salomon T, Rodriguez F, Amthauer M, Erranz B, Castro G, Carreño P, Medina T, Retamal J, Cruces P, Bugedo G, Bruhn A. Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome. Am J Transl Res. 2016 Jun 15;8(6):2826-37.
dc.identifier.urihttp://hdl.handle.net/11447/920
dc.language.isoen_US
dc.publishere-Century Pub. Corp
dc.subjectARDS
dc.subjectECMO
dc.subjectMechanical ventilation
dc.titleExtracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome
dc.typeArtículo

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