DEVELOPMENT OF A MANUALLY OPERATED PORTABLE CARDIOPULMONARY BYPASS FOR EMERGECY RESUSCITATION

最近使用紧急经皮体外循环作为心脏骤停复苏工具的成功是非常令人鼓舞的。然而，即使是便携式心脏搭桥机，也仍然很大很重，无法立即运送到病人身上。它还需要许多人力、特殊技术和电力。体外循环的优势仍然有限。为了简化这一耗时的过程，我们开发了一种手动操作的便携式体外循环系统，用于紧急复苏。该装置由两个带有四个单向阀的自充气硅胶球泵和一个紧凑的人工肺组成。电路的启动体积约为450毫升，启动装置总重量小于2公斤。手动交替按压两个硅胶球泵，血液通过人工膜肺回流股动脉，静脉血通过其中一个储血泵的自充气同时排出。设备最大可提供2.5-3.1L/min的血流量。我们用这种方法对9只狗进行了电流诱导的心脏骤停复苏。在心脏骤停15 ~ 30分钟期间，狗被支持人工操作的体外循环。9只狗均完全康复，无神经系统后遗症。这一创新将提高心肺脑复苏的生存率。

Recent success using emergency percutaneous cardiopulmonary bypass as a tool for resuscitation from cardiac arrest is very encouraging. However even a portable bypass machine is still large and heavy to be immediately transported to a patient. It needs also many man powers, special technique, and electricity. Advantages of cardiopulmonary bypass have remained limited. To facilitate this time consuming process, we developed a manually operated portable cardiopulmonary bypass system for emergency resuscitation. The device is composed of two self-inflating silicone ballon pumps with four one-way valves and a compact artificial lung. The priming volume of the circuit is about 450 ml, and the total weight of the primed device is less than 2 kg. By manual compression of the two silicone ballon pumps alternatively, the blood returns into the femoral artery through the artificial membrane lung, and the venous blood drained out simultaneously by self-inflating of one of the reservoir pumps. The device can provide the blood flow rate of 2.5-3.1L/min at maximum.We applied this method to resuscitate an induced cardiac arrest by electric current in 9 dogs. During a period of cardiac arrest of 15 to 30 min, dogs were supported with the manually operated cardiopulmonary bypass. All of 9 dogs recovered completely without neurological sequelae. This innovation will improve the survival rate of cardiopulmonary cerebral resuscitation.