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1 Department of Medicine, Hinchingbrooke Hospital, Huntingdon, Cambridgeshire, United Kingdom
2 Cambridge Perfusion Services, Papworth Hospital, Papworth Everard, Cambridgeshire, United Kingdom
3 Department of Anaesthetic Research, Papworth Hospital, Papworth Everard, Cambridgeshire, United Kingdom
* To whom correspondence should be addressed. E-mail: colin.borland{at}hinchingbrooke.nhs.uk.
To model lung nitric oxide (NO) and carbon monoxide (CO) uptake a membrane oxygenator circuit was primed with horse blood flowing at 2.5 L min-1. Its gas channel was ventilated with 5 ppm NO, 0.02% CO and 22% O2 at 5 L min-1. DNO and DCO were calculated from inlet and outlet gas concentrations and flow rates. DNO = 13.45 (SD = 5.84) ml.min-1 torr -1 and DCO = 1.22(SD = 0.3) ml.min-1 torr -1. DNO and DCO increased (P =.002) with blood volume/surface area. 1/ DNO (P <.001) and 1/ DCO (P <.001) increased with 1/Hb. DNO (P=.01)and DCO (P =.004)fell with increasing gas flow. DNO but not DCO increased with haemolysis (P =.001) indicating DNO dependence on red cell diffusive resistance. The post haemolysis value for Dm = 41 ml.min-1 torr -1 is the true membrane diffusing capacity of the system.No change in DNO or DCO occurred with changing blood flow rate. 1/DCO increased (P = .009) with increasing pO2. DNO and DCO appear diffusion limited and DCO reaction limited. In this apparatus the red cell and plasma offer a significant barrier to NO but not CO diffusion. Applying the Roughton-Forster model yields similar
NO and
CO to previous estimates. This approach allows alteration of membrane area/blood volume, blood flow, gas flow, oxygen tension, red cell integrity and haematocrit (over a larger range than encountered clinically) while keeping other variables constant . Though structurally very different, it offers a functional model of lung NO and CO transfer.
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