DEVELOPMENT OF A MANUALLY OPERATED PORTABLE CARDIOPULMONARY BYPASS FOR EMERGECY RESUSCITATION

最近使用紧急经皮心肺转流术作为心脏骤停复苏工具的成功是非常令人鼓舞的。然而，即使是便携式旁路机器也仍然很大且很重，不能立即运送到患者。它还需要许多人力、特殊技术和电力。体外循环的优势仍然有限。为了促进这一耗时的过程，我们开发了一种手动操作的便携式心肺转流系统，用于紧急复苏。该装置由两个带有四个单向阀的自充气硅胶气囊泵和一个紧凑型人工肺组成。回路的预充体积约为450 ml，预充器械的总重量小于2 kg。通过两个硅胶球囊泵交替手动加压，血液通过人工膜肺返回股动脉，静脉血通过其中一个储液泵的自充气同时排出。该装置最大可提供2.5-3.1L/min的血流速度，我们应用此方法对9只狗进行了电休克复苏。在15至30分钟的心脏停搏期间，用手动操作的心肺转流术支持犬。所有9只犬均完全恢复，无神经系统后遗症。这一创新将提高心肺脑复苏的存活率。

Recent success using emergency percutaneous cardiopulmonary bypass as a tool for resuscitation from cardiac arrest is very encouraging. However even a portable bypass machine is still large and heavy to be immediately transported to a patient. It needs also many man powers, special technique, and electricity. Advantages of cardiopulmonary bypass have remained limited. To facilitate this time consuming process, we developed a manually operated portable cardiopulmonary bypass system for emergency resuscitation. The device is composed of two self-inflating silicone ballon pumps with four one-way valves and a compact artificial lung. The priming volume of the circuit is about 450 ml, and the total weight of the primed device is less than 2 kg. By manual compression of the two silicone ballon pumps alternatively, the blood returns into the femoral artery through the artificial membrane lung, and the venous blood drained out simultaneously by self-inflating of one of the reservoir pumps. The device can provide the blood flow rate of 2.5-3.1L/min at maximum.We applied this method to resuscitate an induced cardiac arrest by electric current in 9 dogs. During a period of cardiac arrest of 15 to 30 min, dogs were supported with the manually operated cardiopulmonary bypass. All of 9 dogs recovered completely without neurological sequelae. This innovation will improve the survival rate of cardiopulmonary cerebral resuscitation.