The Implantable Pediatric Artificial Lung: Interim Report on the Development of an End-Stage Lung Failure Model.

Published

Journal Article

An implantable pediatric artificial lung (PAL) may serve as a bridge to lung transplantation for children with end-stage lung failure (ESLF); however, an animal model of pediatric lung failure is needed to evaluate the efficacy of PAL before it can enter clinical trials. The objective of this study was to assess ligation of the right pulmonary artery (rPA) as a model for pediatric ESLF. Seven lambs weighing 20-30 kg underwent rPA ligation and were recovered and monitored for up to 4 days. Intraoperatively, rPA ligation significantly increased physiologic dead space fraction (Vd/Vt; baseline = 48.6 ± 5.7%, rPA ligation = 60.1 ± 5.2%, p = 0.012), mean pulmonary arterial pressure (mPPA; baseline = 17.4 ± 2.2 mm Hg, rPA ligation = 28.5 ± 5.2 mm Hg, p < 0.001), and arterial partial pressure of carbon dioxide (baseline = 40.4 ± 9.3 mm Hg, rPA ligation = 57.3 ± 12.7 mm Hg, p = 0.026). Of the seven lambs, three were unable to be weaned from mechanical ventilation postoperatively, three were successfully weaned but suffered cardiorespiratory failure within 4 days, and one survived all 4 days. All four animals that were successfully weaned from mechanical ventilation had persistent pulmonary hypertension (mPPA = 28.6 ± 2.2 mm Hg) and remained tachypneic (respiratory rate = 63 ± 21 min). Three of the four recovered lambs required supplemental oxygen. We conclude that rPA ligation creates the physiologic derangements commonly seen in pediatric ESLF and may be suitable for testing and implanting a PAL.

Full Text

Duke Authors

Cited Authors

  • Alghanem, F; Davis, RP; Bryner, BS; Hoffman, HR; Trahanas, J; Cornell, MS; Rojas-Peña, A; Bartlett, RH; Hirschl, RB

Published Date

  • July 2015

Published In

Volume / Issue

  • 61 / 4

Start / End Page

  • 453 - 458

PubMed ID

  • 25905495

Pubmed Central ID

  • 25905495

Electronic International Standard Serial Number (EISSN)

  • 1538-943X

Digital Object Identifier (DOI)

  • 10.1097/MAT.0000000000000230

Language

  • eng

Conference Location

  • United States