Percutaneous Respiratory Assist Catheter

经皮呼吸辅助导管

• 批准号: 7664586
• 负责人: William J. Federspiel
• 金额: $ 38.94万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7664586
• 关键词: Acute; Acute Lung Injury; Acute respiratory failure; Adjuvant; Adult Respiratory Distress Syndrome; Affect; American; Animals; Bicarbonate Ion; Bicarbonate Ions; Blood; Blood Platelets; Blood flow; Breathing; Caliber; Carbon Dioxide; Cardiovascular system; Catheters; Chronic; Chronic Obstructive Airway Disease; Chronic lung disease; Clinical; Data; Development; Devices; Early treatment; Enzymes; Ethylene Glycols; Evaluation Studies; Excision; Failure; Fiber; Funding; Gases; Glutaral; Goals; Grant; Healed; Health; Healthcare; Heart; Hemolysis; Hospitalization; Hour; Hypercapnia; Imagery; Immobilized Enzymes; Implant; In Situ; Intensive Care Units; Lead; Link; Liquid substance; Lung; Mechanical ventilation; Membrane; Methods; Modeling; Motion; Oxygen; Patients; Pattern; Peripheral; Physiological; Platelet Activation; Pneumonia; Polymers; Proteolysis; Publishing; Pulmonary Emphysema; Research; Rest; Simulate; Site; Societies; Structure; Study models; Surface; Techniques; Translating; Veins; Venous system; aging population; base; biomaterial compatibility; blood oxygenator; carbonate dehydratase; design; ethylene glycol; healing; hemodynamics; improved; lung injury; novel; prototype; public health relevance; respiratory; respiratory assist; response; success; therapy duration; tool

DESCRIPTION (provided by applicant): Each year several hundred thousand Americans suffer short term lung failure requiring respiratory support within the intensive care unit. The objective of this proposal is to develop a percutaneous respiratory assist catheter (PRAC) that can be inserted into the venous system to provide supplemental breathing support, independent of the lungs, for patients requiring short-term (~ 4-7 day) respiratory assistance. The PRAC will be designed for percutaneous insertion into a peripheral vein and placement in the central venous system, where it will be exposed to all the blood returning to the heart. The PRAC will use a rotating impeller within the fiber bundle to generate active mixing of blood to enhance gas exchange. We will also develop novel hollow fiber membranes that incorporate immobilized enzymes that will further accelerate CO2 removal. The specific aims of the project are to: 1. Design and evaluate new mixing impeller structures that increase CO2 removal by increasing fluid motion into and within the hollow fiber bundle. The designs will be developed using computational fluid dynamics (CFD). 2. Develop an enzymatic coating of carbonic anhydrase to accelerate CO2 removal and improve the biocompatibility of hollow fiber membranes. 3. Perform acute (6 hour) and chronic (7 day) calf implants of the PRAC to assess gas exchange, cardiovascular impact, and biocompatibility. Our target is a percutaneous assist catheter (20-25 Fr or smaller) that can provide 90-120 ml/min of CO2 removal when used as an adjuvant or replacement to existing therapy for patients with acute lung failure (ARDS, pneumonia) or acute on chronic lung failure (COPD with exacerbation). PUBLIC HEALTH RELEVANCE several hundred thousand Americans each year suffer from short-term lung failure that requires hospitalization so that breathing support for the patient can be provided. The current methods for providing breathing support to these patients have problems and complications associated with them. The proposed project will develop a simple catheter that can be inserted into a patient's vein to provide breathing support while allowing the lungs to rest and heal.

描述（由申请人提供）：每年有数十万美国人遭受短期肺衰竭，需要在重症监护病房内进行呼吸支持。该提案的目标是开发一种经皮呼吸辅助导管 (PRAC)，可插入静脉系统，为需要短期（约 4-7 天）呼吸辅助的患者提供独立于肺部的补充呼吸支持。 PRAC 将设计用于经皮插入外周静脉并放置在中央静脉系统中，在那里它将暴露于所有返回心脏的血液。 PRAC 将使用纤维束内的旋转叶轮来产生血液的主动混合，以增强气体交换。我们还将开发新型中空纤维膜，其中包含固定化酶，可进一步加速二氧化碳的去除。该项目的具体目标是： 1. 设计和评估新的混合叶轮结构，通过增加中空纤维束内和中空纤维束内的流体运动来增加二氧化碳的去除量。这些设计将使用计算流体动力学（CFD）进行开发。 2、开发碳酸酐酶酶涂层，加速CO2去除，提高中空纤维膜的生物相容性。 3. 进行 PRAC 的急性（6 小时）和慢性（7 天）小腿植入，以评估气体交换、心血管影响和生物相容性。我们的目标是开发一种经皮辅助导管（20-25 Fr 或更小），当用作急性肺衰竭（ARDS、肺炎）或慢性肺衰竭急性发作（COPD 加重）患者现有疗法的辅助或替代疗法时，可提供 90-120 ml/min 的 CO2 清除率。公共卫生相关性每年有数十万美国人患有短期肺衰竭，需要住院治疗，以便为患者提供呼吸支持。当前为这些患者提供呼吸支持的方法存在与之相关的问题和并发症。该项目将开发一种简单的导管，可以插入患者的静脉以提供呼吸支持，同时让肺部得到休息和愈合。