Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Center of Cardiac Surgery for Adults, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Perfusion. 2020 Oct;35(7):680-686. doi: 10.1177/0267659120901675. Epub 2020 Feb 16.
Cardiopulmonary bypass is the basis of open heart surgery. Through simulation-based learning, residents may receive structured training of cardiopulmonary bypass techniques. Therefore, we built a high-fidelity, tissue-based simulation model for cardiopulmonary bypass cannulation/decannulation training.
The core of the model is a whole block of cadaveric animal heart and lung. The discarded membrane oxygenators are used as blood reservoirs. The tubing and suckers recycled from animal experiments are washed and reused. To set up the model, the cadaveric heart and lung are placed into a container of appropriate size. The "arterial" tubing is connected with a pressure gauge, the distal aorta, the superior vena cava, and arterial cannula, respectively. The "venous" tubing is composed of three independent catheters, respectively, for the practice of venous cannulation, for the connection of sucker and for the practice of placing left atrial/ventricular vent. All tubes are installed on the roller pumps to maintain the correct flow direction. A technician should be responsible for operating the heart-lung machine, clamping and releasing the specific segments of tubing, adjusting the pressure, and cooperating with the trainees to practice.
Using the simulation model, 18 residents underwent cardiopulmonary bypass techniques training, with an average satisfaction of 8.94 points. The mean score on the overall fidelity of the simulation model assessed by nine experienced cardiothoracic surgeons was 8.67 points.
The tissue-based simulation model has a certain degree of realism. Cardiac surgery residents can practice necessary cardiopulmonary bypass cannulation/decannulation techniques by this model.
体外循环是心脏直视手术的基础。通过基于模拟的学习,住院医师可以接受体外循环技术的结构化培训。因此,我们构建了一个高保真、基于组织的体外循环插管/拔管训练模拟模型。
该模型的核心是一整块动物心肺组织。废弃的膜式氧合器被用作血库。从动物实验中回收的管道和吸盘经过清洗后重复使用。为了建立模型,将尸体心肺置于合适大小的容器中。“动脉”管道分别与压力表、远端主动脉、上腔静脉和动脉插管相连。“静脉”管道由三根独立的导管组成,分别用于静脉插管练习、连接吸盘和放置左心房/心室引流管练习。所有管道都安装在滚柱泵上,以保持正确的流动方向。一名技术人员应负责操作心肺机,夹闭和松开特定的管道段,调整压力,并与学员合作进行练习。
18 名住院医师使用模拟模型接受了体外循环技术培训,平均满意度为 8.94 分。9 名经验丰富的心胸外科医生对模拟模型整体逼真度的平均评分为 8.67 分。
基于组织的模拟模型具有一定的逼真度。心脏外科住院医师可以通过该模型练习必要的体外循环插管/拔管技术。