EXPERMENTAL STUDY OF ARTIFICIAL PLACENTA ; DOPPLER ECMO CARDIOGRAPHIC EVALUATION OF GOAT FETAL BLOOD FLOW.

本文对人工羊水孵化胎儿进行了实验研究。4只经剖宫产获得的山羊胎儿(平均胎龄125天)经脐动、静脉插管。ECMO电路包括中空纤维型膜氧合器(0.5m2)和自动调节传感器。这些胎儿在人造羊水中孵化。房室分流术由传统的滚柱泵完成，直到心脏骤停。ECMO灌流时间3~70h，平均40h。在ECMO灌流过程中，用脉冲多普勒超声心动图检测动脉导管和胎儿导管的血流速度波形。胎儿的血流动力学取决于ECMO的灌注率，A-V ECMO有利于胎儿获得80~100ml/kg/min的流量。导管闭塞、狭窄改变血流速度波形，导致早期死亡。超声心动图是评价人工胎盘胎儿循环的首选方法。

An expermental study of fetal incubation in artificial amniotic fluid was performed. Four goat fetuses obtained by caesarian incision (average gestational age was 125 days) underwent cannulation through the umbilical arteries and veins. ECMO circuits contained hollowfiber type membrane oxygenators (0.5 m2)and autoregulating sensors. The fetuses were incubated in an artificial amniotic fluid. A-V shunts were performed by a conventional roller pump until cardiac arrest. The duration of ECMO perfusion ranged from 3 to 70 hours with mean of 40 hours. During ECMO perfusion, ductus arteriosus and fetal ductal blood velocity wave forms were evaluated with pulse Dopple echocardiography. Hemodynamics of the fetus undergoing incubation depended on the perfusion rate of ECMO.On A-V ECMO for fetuses, it was advantageous to obtain a flow rate from 80 to 100 ml/kg/min. Ductal occlusion and stenosis changed the blood velocity wave forms, and caused to early death. Doppler echocardiograpic evaluation was the beat way for assessment of fetal circulation in artificial placenta.