Barometric and Hyperoxia Effects During Artificial Membrane Lung
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ABSTRACT
Oxygen is one of the most commonly used therapeutic agents.
Injudicious use of oxygen at high partial pressures (hyperoxia) for unproven indications, its known toxic potential, and the acknowledged roles of reactive oxygen species in tissue injury led to skepticism regarding its use. Nevertheless, a large body of data indicates that hyperoxia exerts an extensive profile of physiologic and pharmacologic effects that improve tissue oxygenation, exert anti-inflammatory and antibacterial effects, and augment tissue repair mechanisms.
These data set the rationale for the use of hyperoxia in a list of clinical conditions characterized by tissue hypoxia, infection, and consequential impaired tissue repair. In the world of Perfusion both Cardiopulmonary Bypass (CPB) both Extracorporeal Membrane Oxygenation (ECMO) the application and use of hypobaric or hyperbaric oxygenation and oxygen at high partial pressures (hyperoxia) during artificial membrane lung (aML) is a controversial topic. Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery.
The arterial filter is a specially designed component for removing both gaseous and solid micro-emboli. In different study hypobaric oxygenation approach capitalizes gaseous micro-embolism (GME) reduction to achieve their near-total elimination during cardiopulmonary bypass (CPB). This review summarizes the pros and cons on hyperbaric or hypobaric oxygenation management and hyperoxia during extracorporeal technologies that used membrane lung oxygenators.
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