Preservation of cardiopulmonary blocks: A real and interactive biomaterial for teaching and learning lung plethysmography and mechanical ventilation
Abstract
The introduction of biomaterials to thoracic training has an important impact on human health and has significant economic benefits. We present a real, reusable and low-cost biomaterial that is a useful tool in teaching and learning training programs for lung plethysmography and mechanical ventilation procedures. At the end of noncardiopulmonary-related research studies, five cardiopulmonary blocks were harvested from rabbits (3), a dog (1) and a cat (1). Cardiopulmonary blocks were preserved with McCormick’s solution and impregnated with glycerin-phenic acid. Subsequently, the cardiopulmonary blocks were connected to a volume ventilator to ensure good lung compliance and that there was no leakage. An acrylic plethysmograph was designed, and cardiopulmonary blocks were placed through an endotracheal tube and connected to a ventilator. Lungs were insufflated under four different inspiratory pressures (10, 12, 14 and 16 cmH2O), and respiratory parameters were calculated. Although it was necessary to significantly increase the inspired tidal volume and the compliance decreased (ANOVA + Student’s t: p<0.05) compared to the values required for blowing non-preserved cardiopulmonary blocks, all the preserved cardiopulmonary blocks maintained their structural integrity, and the lungs were shown to be elastic pieces with smooth texture, along with distension and insufflation capacities. This biomaterial was shown to be functional and reusable for the teaching and learning of lung plethysmography and mechanical ventilation practices.
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Introduction
A comprehensive understanding of respiratory mechanics is pivotal for the accurate diagnosis and treatment of lung disease, adequate application of artificial or assisted ventilation systems and for analyses of environmental effects. It is difficult to obtain an understanding of lung mechanics due to the complex and dynamic nature of pressure-volume relationships of the respiratory system. This is largely attributable to the fact that respiratory mechanics are governed by the mechanics of both the lung and chest wall; the direct visualization of pressure-volume relations can be expected to accelerate and enhance our understanding of respiratory mechanics and considerably increase student motivation to learn about this complex system. 1 Developing real and reusable models for teaching and learning ventilation procedures that mimic respiratory mechanics is essential for the training of clinicians in all the pulmonary specialties and for addressing both ethical and economic issues. A variety of simulation procedures 1 and virtual respiratory models 2 have been developed as tools for teaching. We designed an acrylic box that simulates proper chest function, where pressure differences made it possible to generate the movements that occur during spontaneous respiration or as a result of assisted ventilation. Additionally, we developed training programs to teach surgical skills to human and veterinary medical university students based on cryopreservation3-4 and lyophilization5 methods and obtained excellent results. However, neither of these techniques was useful for tissue preservation that was necessary to obtain a reusable biomaterial. It has been reported that treatment with McCormick solution6 and impregnation with glycerin-phenic acid7 are useful methods for anatomically maintaining different organs.
The aim of this study was to show the feasibility of using a real, reusable and low-cost biomaterial as a tool for teaching and learning training programs on mechanical ventilation using a homemade acrylic box as a thorax simulator.
Conclusion
Cardiopulmonary blocks treated with McCormick solution and impregnated with glycerin-phenic acid were shown to maintain their structural integrity. Lungs are elastic pieces of tissue that have smooth texture with distension and insufflation capabilities. Preserved cardiopulmonary blocks are functional and reusable biomaterials that can be used for pulmonary mechanical ventilation programs. Pressure differences in the thorax (acrylic plethysmograph) were able to generate differences in suction pressure, helping students understand the mechanism of spontaneous breathing and artificial ventilation.