Suenaga E, Naito K, Cao Z L, Suda H, Ueno T, Natsuaki M, Itoh T
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Saga, Japan.
Artif Organs. 2000 Nov;24(11):912-5.
Compactness and high performance are the most important requirements for a cardiopulmonary support system. The Nikkiso (HPM-15) centrifugal pump is the smallest (priming volume; 25 ml, impeller diameter; 50 mm) in clinically available centrifugal pumps. The Kuraray Menox (AL-2000) membrane oxygenator, made of double-layer polyolefin hollow fiber, has a minimum priming volume (80 ml) and a low pressure loss (65 mm Hg at 2.0 L/min of blood flow) compared with other oxygenators. The aim of this study was to evaluate the performance of the most compact cardiopulmonary support system (total priming volume: 125 ml) in animal experiments. The cardiopulmonary bypass was constructed in a canine model with the Nikkiso pump and Menox oxygenator in comparison with a conventional cardiopulmonary support system. The partial cardiopulmonary bypass was performed for 4 h to evaluate the gas exchange ability, blood trauma, serum leakage, hemodynamics, and blood coagulative parameters. The postoperative plasma free hemoglobin level of the compact cardiopulmonary system was 29.5 +/- 10.21 mg/dl (mean +/- SD), which was lower than that of the conventional cardiopulmonary system, 48.75 +/- 27.39 mg/dl (mean +/- SD). This compact cardiopulmonary system provided the advantage in terms of reduction of the priming volume and less blood damage. These results suggested the possibility of miniaturization for the cardiopulmonary bypass support system in open-heart surgery in the near future.
紧凑性和高性能是心肺支持系统最重要的要求。日机装(HPM - 15)离心泵是市面上临床可用的离心泵中体积最小的(预充量25毫升,叶轮直径50毫米)。可乐丽美诺克斯(AL - 2000)膜式氧合器由双层聚烯烃中空纤维制成,与其他氧合器相比,其预充量最小(80毫升)且压力损失低(血流速度为2.0升/分钟时为65毫米汞柱)。本研究的目的是在动物实验中评估最紧凑的心肺支持系统(总预充量:125毫升)的性能。与传统心肺支持系统相比,在犬模型中使用日机装泵和美诺克斯氧合器构建体外循环。进行部分体外循环4小时,以评估气体交换能力、血液损伤、血清渗漏、血流动力学和血液凝固参数。紧凑型心肺系统术后血浆游离血红蛋白水平为29.5±10.21毫克/分升(平均值±标准差),低于传统心肺系统的48.75±27.39毫克/分升(平均值±标准差)。这种紧凑型心肺系统在减少预充量和减少血液损伤方面具有优势。这些结果表明在不久的将来心脏直视手术中心肺旁路支持系统小型化的可能性。