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首次体内评估 RAS-Q 技术作为肺动脉高压的肺部支持设备。

First in vivo assessment of RAS-Q technology as lung support device for pulmonary hypertension.

机构信息

Department of Cardiac Surgery, University Hospitals Leuven and Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.

Enmodes GmbH, Aachen, Germany.

出版信息

Int J Artif Organs. 2021 Apr;44(4):243-250. doi: 10.1177/0391398820954217. Epub 2020 Sep 10.

Abstract

OBJECTIVES

To assess the in vivo hemodynamic effects on the pressure overloaded right ventricle of RAS-Q technology, the world's first gas exchanger with a fully integrated compliance.

METHODS

In six acute in vivo trials RAS-Q was implanted in sheep between the pulmonary artery and left atrium. Right ventricular pressure overload was induced by pulmonary artery banding. Pressures and flows were recorded in baseline, moderate and severe pulmonary hypertension conditions. In one trial, RAS-Q was benchmarked against the pediatric Quadrox-i.

RESULTS

With 1.00 and 1.17 L/min, RAS-Q delivered 31% and 39% of the total cardiac output in moderate and severe pulmonary hypertension, respectively. Pulmonary artery pressures and mean pulmonary artery pressure/mean arterial blood pressure ratio successfully decreased, implying a successful right ventricular unloading. Cardiac output was restored to normal levels in both pulmonary hypertension conditions. With both devices in parallel, RAS-Q provided three times higher flow rates and a 10 times higher pressure relief, compared to the pediatric Quadrox-i.

CONCLUSION

A gas exchanger with a fully integrated compliance better unloads the right ventricle compared to a non-compliant gas exchanger and it can restore cardiac output to normal levels in cases of severe pulmonary hypertension.

摘要

目的

评估 RAS-Q 技术(全球首款具有完全集成顺应性的气体交换器)对压力超负荷右心室的体内血流动力学影响。

方法

在六项急性体内试验中,将 RAS-Q 植入绵羊的肺动脉和左心房之间。通过肺动脉缩窄术诱导右心室压力超负荷。在基线、中度和重度肺动脉高压条件下记录压力和流量。在一项试验中,将 RAS-Q 与儿科 Quadrox-i 进行基准比较。

结果

在中度和重度肺动脉高压下,RAS-Q 的流量分别为 1.00 和 1.17 L/min,分别为总心输出量的 31%和 39%。肺动脉压力和平均肺动脉压/平均动脉血压比值成功降低,表明右心室卸载成功。在两种肺动脉高压情况下,心输出量均恢复正常水平。与儿科 Quadrox-i 相比,在两种设备并行的情况下,RAS-Q 的流量高 3 倍,压力缓解高 10 倍。

结论

与非顺应性气体交换器相比,具有完全集成顺应性的气体交换器能更好地卸载右心室,并在重度肺动脉高压情况下将心输出量恢复正常水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489f/8041442/443872cd8e6a/10.1177_0391398820954217-fig1.jpg

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