Percutaneous Respiratory Assist Catheter

摘要 每年，数十万美国人患有需要呼吸的短期肺衰竭。 重症监护病房内的支持。这项建议的目标是开发一种经皮 可以插入静脉系统的呼吸辅助导管(PRAC)，以提供 为需要短期(~4-7)呼吸支持的患者提供独立于肺的辅助呼吸支持 一天)呼吸辅助。PRAC将被设计为经皮插入外周 静脉和中心静脉系统的放置，在那里它将暴露在所有返回的血液中 心脏。PRAC将使用纤维束中的旋转叶轮来产生主动混合 用血来加强气体交换。我们还将开发新型中空纤维膜，其中包括 固定化的酶，将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，通过增加流体来提高二氧化碳脱除率 运动到中空纤维束和中空纤维束内。这些设计将使用计算工具进行开发 流体动力学(CFD)。 2.开发碳酸酐酶包衣，加速二氧化碳脱除，提高脱碳率。 中空纤维膜的生物相容性。 3.实施PRAC的急性(6小时)和慢性(7天)小腿植入，以评估气体交换， 对心血管的影响和生物相容性。 我们的目标是一种经皮辅助导管(20-25Fr或更小)，可以提供90-120毫升/分钟的 二氧化碳清除作为急性肺病患者现有治疗的辅助或替代 衰竭(ARDS、肺炎)或慢性肺衰竭(COPD伴加重)急性发作。项目叙事 每年有数十万美国人患有短期的肺衰竭，这需要 住院治疗，以便为病人提供呼吸支持。当前的方法用于 为这些患者提供呼吸支持会出现问题和并发症。 拟议中的项目将开发一种简单的导管，可以插入患者的静脉中以 提供呼吸支持，同时让肺部休息和痊愈。

Abstract 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). Project Narrative 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.