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BACKGROUND:Extracorporeal membrane oxygenation(ECMO)adopts heparin-coated oxygenator as key membrane oxygenation,which is a covalent bonding of artificial material surface with mucopolysaccharide on one side of heparin.Thas artificial materials can stimulate human vascular endothelial function partly,leading to decrease production of lactic acid,increase biocompatibility of the matedals,prevent thrombogenesis and relieve inflammatory reaction after operation.OBJECTIVE:To discuss the relationship between the plasma lactic acid level and the prognosis of patients after ECMO applied with heparin-coated oxygenator.DESIGN:Self-controlled clinical study,grouping by age and survival prognosis.SETTING:Department of Cardiopuimonary Bypass,Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences.PARTICIPANTS:Forty patients received ECMO in Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences were selected from December 2004 to September 2006.They suffered from failing weaning of cardiopulmonary bypass postcardioctomy,cardiogenic shock based on dilated cardiomyopathy or cardiogenic shock based on coronary heart disease.All patients were divided into four groups according to age and survival prognosis:adult survival group,adult death group,infant survival group and infant death group.METHODS:All the patients received venoarterial ECMO support treatment.ECMO perfusion system consisted of centrifugal pump,water tank,heparin-coated membrane oxygenator(Jorstra Novalung,Germany)and corollary circuits (Bioline Coating,Germany,batch number:SFDA-I-20063450801).MAIN OUTCOME MEASURES:The concentrations of lactic acid were measured at the ECMO institution,6 hours later,the median time at ECMO support,6 hours before weaning off and at the time of weaning.RESULTS:①In 26 patients of adult groups,20 of them(76.9%)weaned from ECMO,16 of them(61.5%)survived and 10 of them died.In 14 patients of infant groups,7 of them weaned from ECMO(50%),5 of them(35.7%)survived and 9 of them died.②The concentrations of lactic acid in two survival groups were significantly lower than those in death groups(P＜0.05 or 0.001).The concentration decreased significantly at the time points of median time,6 hours before weaning off and at the weaning time,compared with the level at the time of ECMO institution(P＜0.01),indicating a decreasing concentration of lactic acid.CONCLUSION:①The concentration of lactic acid in patients after ECMO decreascs obviously.②Patients with high lactate level at the weaning time show unfavourable prognosis.
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<p><b>OBJECTIVE</b>The fibrogenicity of fur dust was studied in rat lung tissues.</p><p><b>METHODS</b>Intratracheal instillation of fur dust, morphologic examination of lungs and analysis of collagen content were performed in Wistar rats.</p><p><b>RESULTS</b>Morphologic examination revealed that the earliest changes consisted of alveolar edema, increased numbers of intraalveolar macrophages, and marked thickening of interalveolar septa with mixed cellular infiltrate. After sixth months, there was moderate thickening of the alveolar walls and the peribronchioli. After 12 months, interstitial positive fibrosis of the alveolar wall and the peribronchioli were weakly seen. In the carding dust group (silica content 17.6%), interstitial nodules were observed composed of fibroblasts, reticular fibers, and collagen fibers. Electron microscopic examination also showed that alveolar walls became thickened and collagen fiber bundles were seen around bronchioles and small vessels in the carding groups after 12 months. At all stages of analysis, the collagen content in lungs of the fur dust groups was significantly higher than that of the control group.</p><p><b>CONCLUSIONS</b>Our study suggested that fur dust might induce weak interstitial fibrosis in the lung.</p>
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Objective: The fibrogenicity of fur dust was studied in rat lung tissues. Methods: Intratracheal instillation of fur dust, morphologic examination of lungs and analysis of collagen content were performed in Wistar rats. Results: Morphologic examination revealed that the earliest changes consisted of alveolar edema, increased numbers of intraalveolar macrophages, and marked thickening of interalveolar septa with mixed cellular infiltrate. After sixth months, there was moderate thickening of the alveolar walls and the peribronchioli. After 12 months, interstitial positive fibrosis of the alveolar wall and the peribronchioli were weakly seen. In the carding dust group (silica content 17.6%), interstitial nodules were observed composed of fibroblasts, reticular fibers, and collagen fibers. Electron microscopic examination also showed that alveolar walls became thickened and collagen fiber bundles were seen around bronchioles and small vessels in the carding groups after 12 months. At all stages of analysis, the collagen content in lungs of the fur dust groups was significantly higher than that of the control group. Conclusions: Our study suggested that fur dust might induce weak interstitial fibrosis in the lung.