Artificial Organs Laboratory, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Ann Thorac Surg. 2012 Jan;93(1):274-81. doi: 10.1016/j.athoracsur.2011.08.076. Epub 2011 Nov 25.
The purpose of this study was to evaluate the long-term in-vivo hemodynamics, gas transfer, and biocompatibility of an integrated artificial pump-lung (APL) developed for ambulatory respiratory support.
The study was conducted in an ovine model by surgically placing the APL between the right atrium and pulmonary artery. Nine sheep were implanted. Heparin was infused as an anticoagulant. The device flow, gas transfer, and plasma free hemoglobin were measured daily. Hematologic data, platelet activation, and blood biochemistry were assessed twice a week. After 30 days, the sheep were euthanized for postmortem examination. The explanted devices were examined for gross thrombosis.
Five sheep survived for 29 to 31 days and were electively terminated. Four sheep died or were terminated early owing to mechanical failure of intravenous lines or device. The APL devices in the 5 long-term animals were capable of delivering an oxygen transfer rate of 148±18 mL/min at a flow rate of 2.99±0.46 L/min with blood oxygen saturation of 96.7%±1.3%. The device flow and oxygen transfer were stable over 30 days. The animals had normal end-organ functions except for surgery-related transient alteration in kidney function, liver function, and cell and tissue injury. There was no hemolysis. The device flow path and membrane surface were free of gross thrombus.
The APL exhibited the capability of providing respiratory support with excellent biocompatibility, long-term reliability, and the potential for bridging to lung transplant.
本研究旨在评估一种用于日间呼吸支持的集成人工泵肺(APL)的长期体内血液动力学、气体交换和生物相容性。
通过在右心房和肺动脉之间进行手术,将 APL 置于绵羊模型中进行研究。共植入 9 只绵羊。给予肝素作为抗凝剂。每天测量设备流量、气体交换和血浆游离血红蛋白。每周评估两次血液学数据、血小板活化和血液生化。30 天后,处死绵羊进行尸检。检查取出的设备是否有明显血栓。
5 只绵羊存活 29 至 31 天,并被选择性终止。4 只绵羊因静脉输液或设备机械故障而早期死亡或终止。5 只长期动物的 APL 设备能够以 2.99±0.46 L/min 的流速输送 148±18 mL/min 的氧气转移率,血液氧饱和度为 96.7%±1.3%。设备流量和氧气转移在 30 天内保持稳定。动物的终末器官功能正常,除与手术相关的肾功能、肝功能和细胞组织损伤的短暂改变外。无溶血。设备流路和膜表面无明显血栓。
APL 表现出提供呼吸支持的能力,具有出色的生物相容性、长期可靠性和潜在的移植桥接能力。