Tanaka Y
Department of Anesthesiology, Fukushima Medical College.
Masui. 1990 Feb;39(2):154-61.
Silicon hollow fiber membrane oxygenator is considered to be useful for long term extracorporeal membrane oxygenation (ECMO) and blood usually flows inside of the fiber (inside flow type). But if it flows outside of the fiber (outside flow type), the pressure drop is supposed to be less than that of inside flow type. In this study the oxygenator of an outside flow type was used. At first, the pilot study was done to evaluate the capability of this oxygenator as an outside flow type. The pressure drop was 50 mmHg at the blood flow of 400 ml.min-1. At this blood flow and same gas flow, CO2 transfer rate was 22.3 ml.min-1. In the second study, the effects of pumpless arterio-venous ECMO (pumpless A-V ECMO) were studied in 8 dogs under mechanical hypoventilation. During ECMO, there were no significant changes in hemodynamics when the blood flow rate was 15% of cardiac output. PaO2 and PaCO2 recovered considerably. In conclusion, pumpless A-V ECMO using this membrane oxygenator of outside flow type is effective for CO2 removal and considered to be clinically useful.
硅中空纤维膜式氧合器被认为对长期体外膜肺氧合（ECMO）有用，血液通常在纤维内部流动（内流式）。但如果血液在纤维外部流动（外流式），预计压降会低于内流式。在本研究中使用了外流式氧合器。首先，进行了初步研究以评估该氧合器作为外流式的性能。在血流为400 ml·min⁻¹时压降为50 mmHg。在此血流和相同气体流量下，二氧化碳转运速率为22.3 ml·min⁻¹。在第二项研究中，对8只处于机械通气不足状态的犬进行了无泵动静脉ECMO（无泵A-V ECMO）的效果研究。在ECMO期间，当血流速率为心输出量的15%时，血流动力学无显著变化。动脉血氧分压（PaO₂）和动脉血二氧化碳分压（PaCO₂）有相当程度的恢复。总之，使用这种外流式膜式氧合器的无泵A-V ECMO对二氧化碳清除有效，被认为具有临床实用性。
