Peritoneal Oxygenation as a Novel Technique for Extrapulmonary Ventilation; A Review and Discussion of the Literature
- Peritoneal oxygenation has significant potential for treatment of acute respiratory distress syndrome patients.
- It could offer an effective treatment for rescue ventilation in critically unwell patients.
- Further large animal studies are needed with further refinement of currently available techniques.
- We propose the further development of techniques and animal models with an eventual goal of evaluation in humans.
- Peritoneal oxygenation is a promising alternative to rescue ventilation is cases of extreme hypoxia.
2. Peritoneal Membranous Oxygenation Techniques
2.1. Peritoneal Jet Ventilation
2.2. Continuous Low-Pressure Oxygen Flow System in ARDS
2.3. Peritoneal Microbubble Oxygenation
2.4. Intraperitoneal Oxygenated Perfluorocarbon
2.5. Perfusion with Oxygenated Red Blood Cells
3. Future Developments and Limitations
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
|Author||Animal Model||Hypoxia Method||ARDS Method||Delivery Method||Outcome|
|Matsutani et al. (2008) ||Canine [n = 18]||Normoxia maintained through room air MV||N/A||Oxygenated red blood cells and oxygenated saline through peritoneal infusion||Improved systemic oxygenation in both treatment groups when compared to the control group (p < 0.05).|
|Carr et al. (2006) ||Swine [n = 15]||FiO2 reduced to 10%||N/A||Oxygenated perfluorocarbons and oxygenated saline through peritoneal infusion||Mean increase of 12.8 mm Hg (95% CI, 7.4–18.2 mm Hg; p < 0.001) in oxygenated perfluorocarbon arm.|
|Wang et al. (2014) ||Swine [n = 36]||FiO2 progressively reduced||N/A||Peritoneal jet ventilation||Duration of safe apnoea increased, an increased frequency of jet ventilation, the longest safe apnoea duration in the groups at a frequency of 80–120 times a minute.|
|Lemus et al. (2006) ||Swine [n = 4]||ARDS||Oleic acid administered to pulmonary circulation||PEROX||PEROX maintained normal oxygenation indices both prior to and following the outset of ARDS; there was no statistically significant difference in oxygenation prior to or following ARDS.|
|Feshitan et al. (2014) ||Rat [n = 16]||Pneumothorax||N/A||Phospholipid-coated OMBs via PMO given as an intraperitoneal infusion||Group receiving OMBs had a 100% two-hour survival, the oxygenated saline and those who were untreated had a mean survival of 15.5 ± 8.1 min and 16.0 ± 4.8 min, respectively (p < 0.004).|
|Legband et al. (2015) ||Rabbit [n = 19]||Tracheal occlusion||N/A||OMBs via PMO delivered as an intraperitoneal bolus||Increase in the survival duration of those rabbits given an intraperitoneal bolus of OMBs from 6.6 ± 0.6 to 12.2 ± 3.0 min when compared to the control group (p < 0.004).|
|Fiala et al. (2020) ||Rat [n = 23]||ARDS||LPS inhalation||Phospholipid-coated OMBs via PMO given as a bolus||Improved survival of 37% after 48 h between rats given OMB bolus and the no treatment control with higher peripheral blood oxygen saturation. Lower lung wet/dry lung ratio in the OMB treatment group indicating less pulmonary edema.|
- Rawal, G.; Yadav, S.; Kumar, R. Acute Respiratory Distress Syndrome: An Update and Review. J. Transl. Int. Med. 2018, 6, 74–77. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Fan, E.; Del Sorbo, L.; Goligher, E.C.; Hodgson, C.L.; Munshi, L.; Walkey, A.J.; Adhikari, N.K.; Amato, M.B.; Branson, R.; Brower, R.G.; et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am. J. Respir. Crit. Care Med. 2017, 195, 1253–1263. [Google Scholar] [CrossRef]
- Ashbaugh, D.G.; Bigelow, D.B.; Petty, T.L.; Levine, B.E. Acute respiratory distress in adults. Lancet 1967, 2, 319–323. [Google Scholar] [CrossRef] [PubMed]
- Ware, L.B.; Matthay, M.A. The acute respiratory distress syndrome. N. Engl. J. Med. 2000, 342, 1334–1349. [Google Scholar] [CrossRef] [PubMed]
- Makdisi, G.; Wang, I.W. Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology. J. Thorac. Dis. 2015, 7, E166–E176. [Google Scholar]
- Ramanathan, K.; Antognini, D.; Combes, A.; Paden, M.; Zakhary, B.; Ogino, M.; MacLaren, G.; Brodie, D.; Shekar, K. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir. Med. 2020, 8, 518–526. [Google Scholar] [CrossRef][Green Version]
- Singh, I. Absorption of oxygen from the peritoneal cavity and the stomach. Q. J. Exp. Physiol. 1934, 24, 45–54. [Google Scholar] [CrossRef]
- Wagner, E.M.; Jenkins, J.; Perino, M.G.; Sukkar, A.; Mitzner, W. Lung and vascular function during chronic severe pulmonary ischemia. J. Appl. Physiol. (1985) 2011, 110, 538–544. [Google Scholar] [CrossRef][Green Version]
- Legband, N. Development of Peritoneal Microbubble Oxygenation as an Extrapulmonary Treatment for Hypoxia; University of Nebraska: Lincoln, NE, USA, 2017. [Google Scholar]
- Legband, N.; Black, A.; Kreikemeier-Bower, C.; Terry, B.S. Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations. J. Investig. Surg. 2019, 32, 321–330. [Google Scholar] [CrossRef]
- Wang, X.-H.; Li, W.-Y.; Xu, X. Effects of peritoneal oxygenation and hemodynamics during intra-peritoneal jet ventilation at different frequencies in pigs: 5AP1-1. Eur. J. Anaesthesiol. (EJA) 2014, 31, 76. [Google Scholar] [CrossRef]
- Lemus, V.S.; Salazar, M.P.; Arango, W.H.; Tablas, J.L.; Madinabeitia, J.P.; Lewin, D.S.; Menjivar, A.M.; Astacio, N. Supplemental systemic oxygen support with peritoneal oxygenation using a continuous low-pressure oxygen flow system (PEROX). Crit. Care 2006, 10 (Suppl. S1), 61. [Google Scholar] [CrossRef]
- Fiala, A.; Slagle, C.; Legband, N.; Aghabaglou, F.; Buesing, K.; Borden, M.; Harris, S.; Terry, B. Treatment of a Rat Model of LPS-Induced ARDS via Peritoneal Perfusion of Oxygen Microbubbles. J. Surg. Res. 2020, 246, 450–456. [Google Scholar] [CrossRef] [PubMed]
- Feshitan, J.A.; Legband, N.D.; Borden, M.A.; Terry, B.S. Systemic oxygen delivery by peritoneal perfusion of oxygen microbubbles. Biomaterials 2014, 35, 2600–2606. [Google Scholar] [CrossRef] [PubMed]
- Legband, N.D.; Feshitan, J.A.; Borden, M.A.; Terry, B.S. Evaluation of Peritoneal Microbubble Oxygenation Therapy in a Rabbit Model of Hypoxemia. IEEE Trans. Biomed. Eng. 2015, 62, 1376–1382. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Carr, S.R.; Cantor, J.P.; Rao, A.S.; Lakshman, T.V.; Collins, J.E.; Friedberg, J.S. Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation. Chest 2006, 130, 402–411. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Riess, J.G. Fluorocarbon-based in vivo oxygen transport and delivery systems. Vox Sang. 1991, 61, 225–239. [Google Scholar] [CrossRef]
- Day, S.E.; Gedeit, R.G. Liquid ventilation. Clin. Perinatol. 1998, 25, 711–722. [Google Scholar] [CrossRef]
- Shaffer, T.H.; Wolfson, M.R.; Clark, L.C., Jr. Liquid ventilation. Pediatr. Pulmonol. 1992, 14, 102–109. [Google Scholar] [CrossRef]
- Clark, L.C., Jr.; Gollan, F. Survival of mammals breathing organic liquids equilibrated with oxygen at atmospheric pressure. Science 1966, 152, 1755–1756. [Google Scholar] [CrossRef]
- The peritoneum as a novel oxygenation organ: Revitalization of intraperitoneal oxygenation. Shock 2008, 30, 250–253. [CrossRef]
- Teitelbaum, I. Peritoneal dialysis. N. Engl. J. Med. 2021, 385, 1786–1795. [Google Scholar] [CrossRef] [PubMed]
|Gas Exchange Locations||Surface|
|Proportion of Cardiac Output (%)||Membrane|
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Colbourne, J.R.M.; Altoukhi, K.H.; Morris, D.L. Peritoneal Oxygenation as a Novel Technique for Extrapulmonary Ventilation; A Review and Discussion of the Literature. Adv. Respir. Med. 2022, 90, 511-517. https://doi.org/10.3390/arm90060057
Colbourne JRM, Altoukhi KH, Morris DL. Peritoneal Oxygenation as a Novel Technique for Extrapulmonary Ventilation; A Review and Discussion of the Literature. Advances in Respiratory Medicine. 2022; 90(6):511-517. https://doi.org/10.3390/arm90060057Chicago/Turabian Style
Colbourne, James R. M., Khaled H. Altoukhi, and David L. Morris. 2022. "Peritoneal Oxygenation as a Novel Technique for Extrapulmonary Ventilation; A Review and Discussion of the Literature" Advances in Respiratory Medicine 90, no. 6: 511-517. https://doi.org/10.3390/arm90060057