A study about total pulmonary replacement with artificial implantable lung.

人工植入肺全肺置换术的研究。

• 批准号: 07671471
• 负责人: MOTOI Aoe
• 金额: $ 1.6万
• 依托单位: Okayama University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671471/
• 关键词: Artificial lung; Pulmonary replacement; Pulmonary assist; Right heart failure; Pulmonary artery banding; Canine model; Artificial device; Oxygen supply; 完全置換; 体内植え込み式; 肺動脈絞扼

At present, RVAD is commonly used for a right ventricular failure (RVF). In clinic, RVF patients usually suffer poor gas exchange due to cardiac failure. The purpose of this study is whether pumpless ECMO in right ventricle (RV) to left atrium (LA) bypass could be useful as a means of a treatment for a chronic RVF.Experiment I.Ten mongrel dogs (2.5-6.0 kg, mean 3.9kg) were performed banding of the main pulmonary artery (mPA), aimed for RVF due to pulmonary hypertension.A pressure study of the right heart was performed after a long term raising (97-205 days, mean 160 days). All the cases showed the mean RV pressure (m-RVP) [mmHg] >=20 (average 30.2(]SY.+-。[)9.0 mmHg).Experiment II.Implantation of the artificial lung (MENOX EL2000, Kuraray Co.Japan) was performed between RV outlet and LA for ten of the RVF model. As we lost one animal during operation, nine (4.8-8.4kg, mean 6.5kg) were used to evaluate the gas transfer and cardiac function. All the cases showed the m-RVP (average 20.7(]SY.+-。[)4.2mmHg) after the RV-LA hypass was equal to the preoperative value or dropped, and the average cardiac function tended to be improved. Experiment III.After experiment II,the nine dogs were performed ligation of mPA and total RV-LA bypass was started. Five (4.8-8.4kg, mean 6.6kg) of nine RVF model were supported over 6 hours and evaluated the gas transfer and cardiac function (group I), while the other four died soon after ligation of mPA due to RVF.Five non-PA banding mongrels with the membrane oxygenator were used as control (Group II). Group I,as well as Group II,showed good gas transfer rates, averages of 32.5 (]SY.+-。[) 8.3ml/min.of 02 and 37.2 (]SY.+-。[) 11.6ml/min.of CO2 with a blood flow rate of 0.68 (]SY.+-。[) 0.19 L/min..A partial bypass between RV-LA with the commercially available membrane oxygenator provides better recovary of RVF than a total bypass in RVF model.

目前，右室心功能不全(RVF)多采用RVAD治疗。在临床上，RVF患者常因心力衰竭而导致气体交换不良。本研究旨在探讨无泵右室至左心房(RV-LA)体外循环(ECMO)是否可作为治疗慢性RVF的一种方法。实验一.对10只杂种犬(2.5~6.0 kg，平均3.9 kg)施行主肺动脉结扎术(Mpa)，以防治因肺动脉高压引起的RVF。长期抬高(97~205天，平均160天)后进行右心压力研究。所有病例右室平均压(m-RVP)[MmHg]&Gt；=20(平均30.2()Sy.+-)。实验II在10只RVF模型的右室出口与LA之间植入人工肺(MENOX EL2000，Kuraray Co.Japan)。术中失去1只动物，用9只(4.8~8.4 kg，平均6.5 kg)评价气体输送和心功能。所有病例均显示m-RVP，平均20.7(SY+-)。RV-LA术后平均心功能有改善趋势。实验III.实验II后，9只犬结扎Mpa，开始全RV-LA转流。9只RVF模型中5只(4.8~8.4 kg，平均6.6 kg)支持6h以上，评价气体转运和心功能(I组)，另4只因RVF结扎后即刻死亡(II组)。I组和II组表现出良好的气体转移率，平均为32.5(]sy.+-)。[)8.3ml/min，02和37.2(SY+-)。二氧化碳11.6ml/分钟，血流率0.68(Sy.+-)。[)0.19RVF/min.在RV-LA与商用膜氧合器之间的部分转流比在RVF模型中的完全转流提供了更好的RVF恢复。

项目成果

為季 清和、市場 晋吾、青江 基、他: "MENOXTMEL2000のよる人工肺植え込みの実験的検討" 膜型人工肺. 21. 56-60 (1998)

Kiyokazu Tametsuki、Shingo Ichiba、Hajime Aoe 等人：“使用 MENOXTMEL2000 进行氧合器植入的实验研究” 膜氧合器。

Tamesue K., Ichiba S., Aoe M., Kawai T., Yamamoto H., Nawa S., Shimizu N., Tanaka S.: "An experimental study about implantation of artificial lung with MENOX EL 2000" Membrene Artificial Lung. 21. 56-60 (1998)

Tamesue K.、Ichiba S.、Aoe M.、Kawai T.、Yamamoto H.、Nawa S.、Shimizu N.、Tanaka S.：“关于使用 MENOX EL 2000”膜人工肺植入人工肺的实验研究。