School of Clinical Engineering, Faculty of Health and Medical Care, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama, 350-1241, Japan.
Department of Clinical Engineering, National Hospital Organization Sendai Medical Center, 2-11-12, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
J Artif Organs. 2021 Sep;24(3):320-326. doi: 10.1007/s10047-021-01249-5. Epub 2021 Feb 3.
In Japan, perfusionists who work on other clinical tasks are involved in cardiopulmonary bypass. Moreover, the number of cases they can perform is limited. In view of this situation, valve type semi-closed extracorporeal circulation (VACC) was developed as a system that enables extracorporeal circulation (ECC) regardless of perfusionists' experience. The VACC circuit is based on a conventional open-type ECC circuit. A safety valve is installed at the outlet of the reservoir. It is closed by lowering the reservoir pressure below the venous circuit pressure (Pv), thereby providing a closed-type ECC in which the reservoir is separated from the venous circuit (V-circuit). A closed-type ECC needs means to cope with negative pressure generated in the V-circuit and to remove air mixed in the V-circuit. Water experiments to verify the safety of the VACC were conducted. In experiments simulating low venous return, when the Pv dropped, the safety valve opened so that the V-circuit was connected to the reservoir, and the excessive negative pressure was relieved. In the VACC circuit, a bubble trap is installed in the V-circuit, and the air is degassed to the reservoir by a roller pump (D-pump). A water experiment was conducted to verify the principle of the constant degassing method using the D-pump. It verified that the blood storage volume could be maintained constant even if the D-pump is continuously driven. The VACC system provides handling of air mixed in the V-circuit and safety in the case of low venous return.
在日本，从事其他临床任务的灌注师也会参与心肺转流。此外，他们能够进行的手术数量是有限的。鉴于这种情况，开发了瓣膜型半闭体外循环（VACC）系统，作为一种无论灌注师经验如何都能进行体外循环（ECC）的系统。VACC 回路基于传统的开式 ECC 回路。在储液器的出口处安装了一个安全阀。通过将储液器的压力降低到静脉回路压力（Pv）以下，安全阀关闭，从而提供了一种封闭型 ECC，其中储液器与静脉回路（V 回路）隔开。封闭型 ECC 需要一种方法来应对 V 回路中产生的负压，并去除混入 V 回路中的空气。进行了水实验以验证 VACC 的安全性。在模拟低静脉回流的实验中，当 Pv 下降时，安全阀打开，使 V 回路与储液器相连，从而缓解了过大的负压。在 VACC 回路中，V 回路中安装了一个气泡捕集器，通过滚子泵（D-泵）将空气脱气到储液器中。进行了水实验以验证使用 D-泵的恒定脱气方法的原理。它验证了即使连续驱动 D-泵，也可以保持血液储存量恒定。VACC 系统提供了处理 V 回路中混入的空气的方法，并在静脉回流低的情况下提供了安全性。
