Kawahito Shinji, Maeda Tomohiro, Motomura Tadashi, Takano Tamaki, Nonaka Kenji, Linneweber Joerg, Ichikawa Seiji, Ishitoya Hiroshi, Hanazaki Kazuhiro, Glueck Julie, Sato Koshiro, Nosé Yukihiko
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
J Med Invest. 2002 Aug;49(3-4):156-62.
Currently in United States, there are no clinically-applicable hollow fiber extracorporeal membrane oxygenation (ECMO) oxygenators available. Therefore, our laboratory is in the process of developing a silicone hollow fiber membrane oxygenator for long-term ECMO usage. This oxygenator incorporates an ultrathin silicone hollow fiber. At this time, a specially-modified blood flow distributor (one chamber distributor) is centered in the module to prevent blood stagnation. An ex vivo long-term durability test for ECMO was performed using a healthy miniature calf for 2 weeks. Venous blood was drained from the left jugular vein of a calf, passed through the oxygenator and infused into the left carotid artery using a Gyro C1E3 centrifugal blood pump. A successful 2-week ex vivo experiment was performed. The O2 and CO2 gas transfer rates were maintained at the same value of 40 m/min at a blood flow rate of 1 L/min flow and V/Q=3 (V=gas flow rate; Q=blood flow rate). The plasma free hemoglobin was maintained around 5 mg/dl. After the experiment, no blood clot formation was observed in the module and no abnormal necropsy findings were found. These data suggest that the performance of this newly-improved oxygenator was stable, reliable, and acceptable for long-term ECMO.
目前在美国，尚无临床适用的中空纤维体外膜肺氧合（ECMO）氧合器。因此，我们实验室正在研发一种用于长期ECMO的硅酮中空纤维膜氧合器。这种氧合器采用了超薄硅酮中空纤维。此时，一个经过特殊改良的血流分配器（单腔分配器）位于模块中心，以防止血液停滞。使用一只健康的小型小牛进行了为期2周的ECMO体外长期耐久性测试。从小牛的左颈静脉引流静脉血，通过氧合器，然后使用Gyro C1E3离心血泵注入左颈动脉。成功进行了为期2周的体外实验。在血流速度为1 L/min且V/Q = 3（V =气体流速；Q =血流速度）时，氧气和二氧化碳的气体传输速率维持在40 m/min的相同值。血浆游离血红蛋白维持在5 mg/dl左右。实验结束后，在模块中未观察到血栓形成，尸检也未发现异常结果。这些数据表明，这种新改进的氧合器性能稳定、可靠，适用于长期ECMO。
