A systematic approach for an improved patient-device-connection to allow a long-term lung assist (ConnLA)

改进患者与设备连接以实现长期肺部辅助的系统方法 (ConnLA)

• 批准号: 346973239
• 负责人: Professorin Dr.-Ing. Jutta Arens
• 金额: --
• 依托单位: Institut für Angewandte Medizintechnik (AME)
• 依托单位国家: 德国
• 项目类别: Priority Programmes
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/346973239?language=en
• 关键词: systematic; approach; improved; patient; device

Aim of SPP 2014 is to enable research to support the development of long-term implantable lung assist systems. The cannulation of Extracorporeal Lung Assist (ECLA) systems is still a source of undesired complications such as recirculation due to a malposition of the cannula, ischemia of the averted body parts, and formation of (micro-)thrombi at the cannula tip due to non-physiologic flow conditions. These complications can result in an ineffective and possibly harming treatment and a reduction of the operating time of the ECLA system due to clotting and clogging. The latter requires a higher frequency of component changes which adds to the risks for the patient.Therefore, a new systematic approach to connect the ECLA system to the patient is necessary, which addresses these complications and thus may represent an important step towards a long-term stable and implantable artificial lung system. The present project aims for an alternative to conventionally used cannula such as hemodynamically optimized grafts directly connected to blood vessels. The intention is to provide a reliable blood flow into the extracorporeal circuit without (micro-)thrombi formation and/or prevention of suction of the cannula tip to the vessel wall on one hand and a return of the oxygenated blood on the other hand, which causes low shear stress to the vessel wall, provides a good mixing with the natural blood flow and no recirculation to the withdrawal point.In order to accomplish this aim, the minimal and maximal demand of extracorporeal blood flow needs to be determined for therapy concepts tailored to different entities of lung disease (e. g. lung assist with mere CO2 removal or combined oxygenation and CO2 removal with venovenous ECLA). Suitable blood vessels will be identified with the support of imaging methods and the optimal graft shape and optimal positioning, regarding angle of flow, mixing, shear stresses, and spatial position relative to other anatomic structures, will be investigated using numerical simulation and flow visualization methods. Based on these data, novel graft designs will be explored and tested in vitro. Finally, these in-vitro test results will be validated in an acute animal test series. Further in-vivo testing in a chronic animal test series is planned for a second grant period.Planned project duration: 36 month followed by a continuative application for 36 month

SPP 2014的目标是使研究能够支持长期植入式肺辅助系统的开发。体外肺辅助(ECLA)系统的插管仍然是不良并发症的来源，如由于插管位置错误而导致的再循环，避免的身体部位的缺血，以及由于非生理性流动条件而在插管尖端形成(微小)血栓。这些并发症可能导致无效和可能有害的治疗，并由于凝血和堵塞而缩短ECLA系统的操作时间。后者需要更高频率的成分改变，这增加了患者的风险。因此，需要一种新的系统化方法来连接ECLA系统和患者，以解决这些并发症，从而可能是迈向长期稳定和可植入的人工肺系统的重要一步。本项目旨在寻找一种替代传统使用的插管的方法，例如直接与血管相连的血液动力学优化的移植物。其目的是为体外循环提供可靠的血液流动，而不会形成(微小)血栓和/或防止导管尖端吸入到血管壁，另一方面防止充氧血液回流，这会导致对血管壁的低剪应力，提供与自然血流的良好混合，并且不会再循环到取出点。为了实现这一目标，需要为不同的肺部疾病定制的治疗概念确定体外血流的最小和最大需求量(例如，肺辅助单纯的二氧化碳清除或结合氧合和二氧化碳清除与静脉静脉ECLA)。在成像方法的支持下，将识别合适的血管，并将使用数值模拟和流动可视化方法来研究最佳移植物形状和最佳位置，包括流动角度、混合、剪应力和相对于其他解剖结构的空间位置。基于这些数据，将在体外探索和测试新的移植物设计。最后，这些体外试验结果将在急性动物试验系列中得到验证。慢性动物试验系列的进一步体内试验计划在第二个资助期内进行。计划的项目持续时间：36个月，然后继续申请36个月