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Pulsatile flows to improve function of a long-term oxygenator

脉动流可改善长期氧合器的功能

基本信息

批准号：
265106560
负责人：
Professor Dr. Rolf Rossaint
金额：
--
依托单位：
Klinik für Anästhesiologie
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2014
资助国家：
德国
起止时间：
2013-12-31 至 2018-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/265106560?language=en
关键词：
Pulsatile flows improve function long

项目摘要

Despite technical advancements, long-term durability of oxygenators in Extracorporeal Membrane Oxygenation (ECMO) circuits is still limited to 1 - 2 weeks. Prolongation of the period of use is especially necessary regarding novel long-term applications such as bridge-to-lung transplant or treatment of chronic obstructive lung disease. The aim of this project is the investigation of the influence of pulsatile blood flow within an ECMO circuit regarding gas transfer efficiency and hemocompatibility, and thus a prolonged period of use. Therefore, we plan to systematically investigate pulsatile and non-pulsatile flows within ECMO systems regarding the long-term performance of oxygenators and the effects on the hemocompatibility considering the coagulation and the activation of the immune system. Following objectives are to be achieved in several steps: 1. Theoretically, prevention of areas of stagnating flow and an improved gas transfer efficiency due to induced secondary flows can be achieved by pulsatile flows. In order to obtain fundamental understanding of the optimum flow profile, regarding mean and maximum amplitude and cycle duration, different profiles have to be defined and developed first, taking advantage of existing medical and medical-technical knowledge. 2. Initial in-vitro experiments aiming to decrease the number of flow profiles under investigation will be enabled by the development of a demonstrator. The influence of pulsatility on gas exchange efficiency is to be investigated first. 3. On basis of the identified flow profiles, demonstrator and control are optimized. Subsequently, an in-vitro test series is carried out to systematically examine pulsatile and non-pulsatile flow profiles with respect to the effects on gas exchange, flow rates, and hemocompatibility. In addition to gas exchange and blood traumatization, parameters for coagulation and immune system are measured with human blood. Finally, a scanning electron microscope and immunohistopathological analysis of the oxygenator fibers are planned. The results of this project will enable a verification of the theoretical advantages of the pulsatility, i. e. if a pulsatile flow leads in fact to enhanced efficiency and long-term stability of an ECMO system. Subsequently, the characterization of an ideal flow profile can be used to evaluate the long-term stability of a lung support system in in-vivo experiments and to investigate the effects on different organ systems in a follow-up application. Ultimately, in case of positive test results, the goal of a more efficient and a prolonged extracorporeal lung support could be achieved.

尽管技术进步，体外膜氧合（ECMO）回路中氧合器的长期耐用性仍限于1 - 2周。对于新的长期应用，如肺桥移植或慢性阻塞性肺疾病的治疗，延长使用时间尤其必要。本项目的目的是研究ECMO回路内脉动血流对气体传输效率和血液相容性的影响，从而延长使用时间。因此，我们计划系统地研究ECMO系统内的脉动流和非脉动流，以了解氧合器的长期性能以及对血液相容性的影响，同时考虑凝血和免疫系统的激活。以下目标将分几步实现：1.理论上，通过脉动流可以防止停滞流的区域，并由于诱导的二次流而提高气体传输效率。为了获得关于平均和最大振幅以及循环持续时间的最佳流量曲线的基本理解，必须首先利用现有的医学和医学技术知识来定义和开发不同的曲线。2.初步的体外实验，旨在减少正在调查的流量剖面的数量将能够通过开发一个演示。首先研究脉动性对气体交换效率的影响。3.在识别出的流场的基础上，对演示器和控制器进行了优化。随后，进行了一系列体外试验，以系统地检查脉动流和非脉动流对气体交换、流速和血液相容性的影响。除了气体交换和血液创伤，凝血和免疫系统的参数测量与人类血液。最后，扫描电子显微镜和免疫组织病理学分析的氧合纤维计划。该项目的结果将能够验证的脉动，即理论上的优势。e.如果脉动流实际上导致ECMO系统的增强的效率和长期稳定性。随后，理想的流量曲线的表征可用于在体内实验中评估肺支持系统的长期稳定性，并在后续应用中研究对不同器官系统的影响。最终，如果检测结果为阳性，则可以实现更有效和更长时间的体外肺支持的目标。