Feasibility study of an artificial placenta system consisting of a loop circuit configuration extracorporeal membrane oxygenation with a bridge circuit in the form of the umbilical arterial?venous connection
Feasibility study of an artificial placenta system consisting of a loop circuit configuration extracorporeal membrane oxygenation with a bridge circuit in the form of the umbilical arterial?venous connection
复制标题
人工胎盘系统的可行性研究，该系统由环路配置体外膜氧合和脐动脉静脉连接形式的桥路组成
DOI：
10.1007/s10047-022-01370-z
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发表时间：
2022
影响因子：
1.3
通讯作者：
Murakami Takashi
中科院分区：
文献类型：
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作者：
Inatomi Ayako;Nishinaka Tomohiro;Umeki Akihide;Tsukiya Tomonori;Katagiri Nobumasa;Fujii Masahiko;Kobayashi Futoshi;Imaoka Syusuke;Tanaka Shun;Mizuno Toshihide;Murakami Takashi
我们开发了一种新型人工胎盘 (AP) 系统，由循环回路配置体外膜氧合 (ECMO) 和桥式回路组成，旨在以脐动脉-静脉连接的形式应用于胎儿。我们的目的是通过使用机械模拟循环系统和胎儿动物实验进行流体动力学模拟来评估 AP 系统的可行性。假设胎儿体重为 2 kg，使用机械模拟循环系统进行流体动力学模拟，评估 AP 系统工作条件对胎儿血流动力学的影响。 AP 系统被引入两只胎龄为 135 天的胎山羊身上。评价实验动物的一般状况。模拟模拟表明，在具有脐动脉-静脉串联连接形式的 ECMO 的 AP 系统中，当应用高 ECMO 流量时，可能难以维持胎儿血流动力学。开发的 AP 系统可以在脐血流量较少的情况下实现较高的 ECMO 流量；然而，应注意胎儿右侧心脏负荷过重的可能性。在动物实验中，1 号孩子（1.9 公斤）在 AP 系统上维持 12 天，并使其生长至足月。 2 号孩子（1.6 公斤）由于血栓阻塞，AP 系统无法建立。所开发的 AP 系统在体外和体内条件下都是可行的。 AP 系统的改进和一般胎儿状况的管理至关重要。
We developed a new artificial placenta (AP) system consisting of a loop circuit configuration extracorporeal membrane oxygenation (ECMO) with a bridge circuit designed to be applied to the fetus in the form of an umbilical arterial–venous connection. We aimed to evaluate the feasibility of the AP system by performing a hydrodynamic simulation using a mechanical mock circulation system and fetal animal experiment. The effect of the working condition of the AP system on the fetal hemodynamics was evaluated by hydrodynamic simulation using a mechanical mock circulation system, assuming the weight of the fetus to be 2 kg. The AP system was introduced to two fetal goats at a gestational age of 135 days. The general conditions of the experimental animals were evaluated. The mock simulation showed that in an AP system with ECMO in the form of an umbilical arterial–venous connection in series, it could be difficult to maintain fetal hemodynamics when high ECMO flow was applied. The developed AP system could have high ECMO flow with less umbilical blood flow; however, the possibility of excessive load on the fetal right-sided heart should be noted. In the animal experiment, kid 1 (1.9 kg) was maintained on the AP system for 12 days and allowed to grow to term. In kid 2 (1.6 kg), the AP system could not be established because of the occlusion of the system by a thrombus. The developed AP system was feasible under both in vitro and in vivo conditions. Improvements in the AP system and management of the general fetal conditions are essential.