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Development of an ultracompact integrated heart-lung assist device for long-term cardiopulmonary support

开发用于长期心肺支持的超紧凑集成心肺辅助装置

基本信息

批准号：
08407041
负责人：
TATSUMI Eisuke
金额：
$ 21.31万
依托单位：
National Cardiovascular Center Research Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08407041/
关键词：
Artificial lung Centrifugal pump Integrated heart-lung assist device Percutaneous Cardiopulmonary Support Heparin-bonding surface treatment Bridge use to lung or heart-lung transplantation smaller diameter hollow fiber Preprimed preservation

项目摘要

The purpose of this research is to develop a novel integrated heart-lung assist device which is not only a simple-to-use ultra-compact cardiopulmonary support system but also a system usable for long-term bridge to lung or heart-lung transplantation. The device comprises a centrifugal pump and an artificial lung which is located around the pump to be and all-in-one system. The special polyolefin-made hollow fiber membrane, in which micropores are blind-ended to preclude plasma breakthrough in protracted use and to enable preprimed setup, was developed and employed. this hollow fiber was designed to have a smaller diameter than usual one to obtain effective convective mixing in a extracapillary blood flow fashion. Test lungs consisting of the same membrane well preserved gas-exchange function after 3 months preprimed storage. The entire blood-contacting surface is treated with newly-developed covalently heparin bonding to impart good antithrombogenicity. Heparin bonded test lungs could be continuously perfused without systemic anticoagulation for as long as 36 days in venoarterial bypass chronic animal study using goats. The third iteration prototype device (diameter: 13 cm, height: 5 cm, membrane area: 1.5 mィイD12ィエD1, priming volume: 165 ml) acquired ideal flow condition in the device by realizing sprinkler-like blood flow pattern from the centrifugal pump compartment to the cylindrical artificial lung compartment with circumferentially located diffusers. In in vitro and ex vivo evaluation studies, the device demonstrated 5 L/min pump output at 200 mm Hg pressure head, and 225 ml/min oxygen and 160 ml/min carbon dioxide transfer rates at 5 L/min blood flow. We conclude that this device has a potentiality to be the next generation cardiopulmonary support system which can be used for long-term without systemic anticoagulation.

本研究的目的是开发一种新型的集成心肺辅助装置，它不仅是一种易于使用的超紧凑心肺支持系统，而且是一种可用于长期肺桥或心肺移植的系统。该装置包括一个离心泵和一个位于泵周围的一体化系统的人工肺。开发并采用了特殊的聚烯烃制成的中空纤维膜，其中微孔是盲端的，以防止长期使用中的等离子体突破并实现预底漆设置。这种中空纤维的直径被设计得比普通纤维更小，以便以毛细血管外血流方式获得有效的对流混合。由相同膜组成的测试肺在预启动储存 3 个月后仍保持良好的气体交换功能。整个血液接触表面经过新开发的共价肝素键处理，具有良好的抗血栓形成性。在使用山羊进行的静脉动脉旁路慢性动物研究中，肝素结合的测试肺可以在不进行全身抗凝的情况下连续灌注长达 36 天。第三次迭代原型装置（直径：13 cm，高度：5 cm，膜面积：1.5 mィイD12ィエD1，预充量：165 ml）通过实现从离心泵室到具有圆周分布扩散器的圆柱形人工肺室的喷头式血流模式，在装置中获得了理想的流动条件。在体外和离体评估研究中，该装置在 200 毫米汞柱压头下显示出 5 升/分钟的泵输出，在 5 升/分钟血流量下显示出 225 毫升/分钟的氧气和 160 毫升/分钟的二氧化碳传输速率。我们的结论是，该设备有潜力成为下一代心肺支持系统，可以长期使用而无需全身抗凝。