Enhancement of an Artificial Lung for Ambulatory Respiratory Support

急性和慢性终末期肺部疾病(ESLD)正在增加医疗保健问题。目前，当 机械通气仅通过设计组件进行体外膜氧合(ECMO)失败 并且有几个小时的资格是可用的。目前的ECMO系统通常与严重的 并发症，一般仅限于床边使用。一种可穿戴、生物兼容的一体化泵-肺 将为患者提供比现有选择更大的优势。这样的装置会造成长时间的 用于急性损伤的自然肺愈合的可移动平台，通向移植或目的地治疗的桥梁，或 用于新的肺再生疗法。在NHLBI的支持下，我们在以下方面取得了显著进展 用于门诊呼吸支持的可穿戴人工泵-肺系统(APLS)的开发。的目标是 这一更新应用是为了开发一种新型的具有自适应生理控制的气体交换装置 一种可穿戴的人工肺系统。 我们建议开发独特的策略来减小气体交换设备和相关驱动器的尺寸 并为非卧床ECMO患者提供适应性呼吸支持。的三个具体目标 建议：(1)开发一种小型多功能膜呼吸辅助装置(MRAD)，用于 门诊环境下的ECMO疗法。新型MRAD将包括一个双室气体交换器(DCGE) (2)为MRAD开发了一个轻便的控制台 具有基于病人换气需求的自适应控制。便携式控制台 将不超过20磅，并可放入背包；及(3)进行体外监管资格 测试和慢性(30天)体内动物实验，以评估长期功能，生物相容性，和 MRAD的持久性及其对动物的生物效应。 新气体交换设备的效率将使其尺寸和控制台减少近30%。被缩减的 控制台的大小和重量将减轻用户的负担，并允许将其配置到背包中 设计以及一个小型滚筒外壳。AIMS的完成将重新定义适用于 扩大了非卧床ECMO的使用范围，并将其用于医院外。

Acute and chronic end-stage lung diseases (ESLD) are increasing healthcare problems. Currently, when mechanical ventilation fails only extracorporeal membrane oxygenation (ECMO) with components designed and qualified for a few hours is available. Current ECMO systems are often associated with serious complications and generally are restricted to bedside use. A wearable, biocompatible integrated pump-lung would offer significant advantages to patients over existing options. Such a device would pose a prolonged ambulatory platform for natural lung healing from acute injury, a bridge to transplant or destination therapy, or for novel lung regenerative therapies. With support from the NHLBI, we have made remarkable progress in development of a wearable artificial pump-lung system (APLS) for ambulatory respiratory support. The goal of this renewal application is to develop a new class of gas exchange device with adaptive physiologic control for a wearable artificial lung system. We propose to develop unique strategies to reduce the sizes of gas exchanger devices and associated drive consoles and to provide adaptive respiratory support to ambulating ECMO patients. Three specific aims of the proposal are: (1) to develop a small-sized and multifunctional membrane respiratory assist device (MRAD) for ECMO therapy in the ambulatory setting. The novel MRAD will include a dual chamber gas exchanger (DCGE) for blood and gas flows with an integrated centrifugal pump; (2) to develop a lightweight console for the MRAD with auto-adaptive control based on the gas exchange demand of an ambulating patient. The portable console will be less than 20 lbs and can be placed into a backpack; and (3) to conduct in-vitro regulatory qualification tests and chronic (30-day) in-vivo animal experiments to assess the long-term function, biocompatibility, and durability of the MRAD and its biologic effect on the animal. The efficiency of the new gas exchange device will reduce its size and its console by near 30%. The reduced console size and weight will reduce its burden to the user and will permit its configuration into a backpack design as well as a small roller case. Completion of aims will redefine the technology appropriate for broadened use of ambulatory ECMO and for its out-of-hospital use.