Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata, Japan.
Department of Science and Engineering, Tokyo Denki University, Hatoyama, Japan.
Artif Organs. 2021 Jan;45(1):63-67. doi: 10.1111/aor.13769. Epub 2020 Jul 30.
Recently, veno-venous extracorporeal membrane oxygenation (V-V ECMO) has been commonly used in the world to support patients with severe respiratory failure. However, V-V ECMO is a new technology compared to veno-arterial extracorporeal membrane oxygenation and cardiopulmonary bypass, and there are few reports of basic research. Although continuing research is desired, clinical research that standardizes conditions such as patients' background characteristics is difficult. The purpose of this study was to establish a simple and stably maintainable miniature V-V ECMO model to study the mechanisms of the biological reactions in circulation during V-V ECMO. The V-V ECMO system consisted of an original miniature membrane oxygenator, polyvinyl chloride tubing line, and roller pump. The priming volume of this system was only 8 mL. Polyethylene tubing was used to cannulate the right femoral vein as the venous return cannula for the V-V ECMO system. A 16-G cannula was passed through the right internal jugular vein and advanced into the right atrium as the conduit for venous uptake. The animals were divided into 2 groups: SHAM group and V-V ECMO group. V-V ECMO was initiated and maintained at 50-60 mL/kg/min, and oxygen was added into the oxygenator during V-V ECMO at a concentration of 100% (pump flow:oxygen = 1:10). Blood pressure was measured continuously, and blood cells were measured by blood collection. During V-V ECMO, the blood pressure and hemodilution rate were maintained around 80 mm Hg and 20%, respectively. Hb was kept at >10 g/dL, and V-V ECMO could be maintained without blood transfusion. It was possible to confirm oxygenation of and carbon dioxide removal from the blood. Likewise, the pH was adequately maintained. There were no problems with this miniature V-V ECMO system, and extracorporeal circulation progressed safely. In this study, a novel miniature V-V ECMO model was established in the rat. A miniature V-V ECMO model appears to be very useful for studying the mechanisms of the biological reactions during V-V ECMO and to perform basic studies of circulation assist devices.
最近，静脉-静脉体外膜肺氧合（V-V ECMO）已在全球范围内广泛用于支持严重呼吸衰竭的患者。然而，与静脉-动脉体外膜肺氧合和体外循环相比，V-V ECMO 是一项新技术，基础研究较少。尽管人们希望继续进行研究，但很难进行规范患者背景特征等条件的临床研究。本研究旨在建立一种简单且可稳定维持的微型 V-V ECMO 模型，以研究 V-V ECMO 期间循环中生物反应的机制。V-V ECMO 系统由原始的微型膜式氧合器、聚氯乙烯管路和滚柱泵组成。该系统的预充量仅为 8 毫升。使用聚乙烯管作为静脉回流管，通过右侧股静脉进行插管，为 V-V ECMO 系统提供静脉摄取。动物分为 2 组：SHAM 组和 V-V ECMO 组。V-V ECMO 以 50-60 毫升/千克/分钟的速度启动并维持，在 V-V ECMO 期间向氧合器中添加 100%的氧气（泵流量：氧气= 1:10）。连续测量血压，通过采血测量血细胞。在 V-V ECMO 期间，血压和血液稀释率分别维持在 80mmHg 左右和 20%左右。Hb 保持在>10g/dL，无需输血即可维持 V-V ECMO。可以确认血液的氧合和二氧化碳去除。同样，pH 值得到充分维持。该微型 V-V ECMO 系统没有问题，体外循环安全进行。在这项研究中，在大鼠中建立了一种新型微型 V-V ECMO 模型。微型 V-V ECMO 模型似乎非常有助于研究 V-V ECMO 期间生物反应的机制，并进行循环辅助装置的基础研究。
