Development of a Total Artificial Lung

全人工肺的研制

• 批准号: 6695274
• 负责人: Robert H. Bartlett
• 金额: $ 97.87万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-01 至 2006-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6695274
• 关键词: bioengineering /biomedical engineering; biomedical equipment development; carbon dioxide; hemodynamics; implant; lung; lung disorder; lung transplantation; medical implant science; prosthesis; respirators; respiratory function; respiratory gas; respiratory gas transport; sheep; vascular resistance

The use of mechanical devices ("artificial organs") to replace vital organ function in acute or chronic organ failure has gone from theory to the intensive care bedside in the last 40 years. For 30 of those years our research on artificial organs has been supported by NIH, resulting in devices and techniques now used clinically to treat lung, heart, kidney, and liver failure. One of these techniques (Extracorporeal Life Support, ECMO) can replace lung function for weeks resulting in recovery of otherwise fatal acute lung disease. But ECMO is too complex and invasive to serve as a bridge to lung transplantation. A bridging system is needed because most of the patients listed for lung transplantation die on the waiting list, and because many potential lung donors are not accepted because borderline lung function might prove fatal in the postoperative period without mechanical support. An implantable prosthetic lung which could function for 3-6 months would solve both of these problems, just as the ventricular assist device has been applied to cardiac failure and transplantation. We have applied the expertise of our laboratory to the development of a paracorporeal/implantable total artificial lung; perfused by the right ventricle and capable of total respiratory support. We have demonstrated safety and efficacy of a prototype design during seven days of implantation in sheep. Based on our preliminary studies demonstrating proof of principle, we propose to design and test a total artificial lung to the point of initial clinical trials. In this proposal, we further intend to establish a new collaboration and partnership between medical researchers and bioengineers who have specific expertise in fluid dynamics, gas transport, artificial organ development, extracorporeal support, and pulmonary physiology to develop and refine a TAL such that it can be implanted successfully as a total lung replacement.

在过去的40年里，使用机械装置（“人造器官”）来替代急性或慢性器官衰竭中的重要器官功能已经从理论发展到重症监护床边。 其中30年来，我们对人造器官的研究一直得到NIH的支持，导致现在临床上用于治疗肺，心脏，肾脏和肝脏衰竭的设备和技术。 其中一种技术（体外生命支持，ECMO）可以取代肺功能数周，导致致命的急性肺疾病的恢复。 但ECMO过于复杂和侵入性，无法作为肺移植的桥梁。 需要一个桥接系统，因为大多数肺移植患者在等待名单上死亡，而且许多潜在的肺供体不被接受，因为边缘肺功能可能在术后期间没有机械支持而致命。 一个可以工作3-6个月的植入式人工肺将解决这两个问题，就像心室辅助装置已经应用于心力衰竭和移植一样。我们已将我们实验室的专业知识应用于开发一种由右心室灌注并能够提供全呼吸支持的旁肺/植入式全人工肺。 我们已经证明了原型设计在绵羊体内植入7天期间的安全性和有效性。 基于我们的初步研究证明的原则，我们建议设计和测试全人工肺的初步临床试验。 在本提案中，我们进一步打算在具有流体动力学、气体输送、人工器官开发、体外支持和肺生理学专业知识的医学研究人员和生物工程师之间建立新的合作和伙伴关系，以开发和改进TAL，以便它可以作为全肺替代品成功植入。