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一种用于小儿终末期肺衰竭的低阻力、同心门控人工膜肺。

A Reduced Resistance, Concentric-Gated Artificial Membrane Lung for Pediatric End-Stage Lung Failure.

作者信息

Wich Lauren A, Gudex Leah M, Dann Tyler M, Matich Hannah J, Thompson Alex J, Atie Michael, Johnson Matthew D, Bartlett Robert H, Rojas-Peña Alvaro, Hirschl Ronald B, Potkay Joseph A

机构信息

From the Department of Surgery and ECLS Laboratory, University of Michigan Medical School, Ann Arbor, MI.

Department of Surgery, Section of Transplantation, University of Michigan, Ann Arbor, MI.

出版信息

ASAIO J. 2025 Mar 1;71(3):254-262. doi: 10.1097/MAT.0000000000002308. Epub 2024 Sep 13.

Abstract

The goal of the low-resistance pediatric artificial lung (PAL-LR) is to serve as a pumpless bridge-to-transplant device for children with end-stage lung failure. The PAL-LR doubles the exposed fiber length of the previous PAL design. In vitro and in vivo studies tested hemocompatibility, device flow, gas exchange and pressure drop performance. For in vitro tests, average rated blood flow (outlet SO 2 of 95%) was 2.56 ± 0.93 L/min with a pressure drop of 25.88 ± 0.90 mm Hg. At the targeted pediatric flow rate of 1 L/min, the pressure drop was 8.6 mm Hg compared with 25 mm Hg of the PAL. At rated flow, the average O 2 and CO 2 transfer rates were 101.75 ± 10.81 and 77.93 ± 8.40 mL/min, respectively. The average maximum O 2 and CO 2 exchange efficiencies were 215.75 ± 22.93 and 176.99 ± 8.40 mL/(min m 2 ), respectively. In vivo tests revealed an average outlet SO 2 of 100%, and average pressure drop of 2 ± 0 mm Hg for a blood flow of 1.07 ± 0.02 L/min. Having a lower resistance, the PAL-LR is a promising step closer to a pumpless artificial membrane lung that alleviates right ventricular strain associated with idiopathic pulmonary hypertension.

摘要

低阻力儿科人工肺(PAL-LR)的目标是作为终末期肺衰竭儿童的无泵式移植过渡设备。PAL-LR使先前PAL设计的暴露纤维长度增加了一倍。进行了体外和体内研究,以测试血液相容性、设备流量、气体交换和压降性能。在体外测试中,平均额定血流量(出口处SO₂为95%)为2.56±0.93升/分钟,压降为25.88±0.90毫米汞柱。在目标儿科流速1升/分钟时,压降为8.6毫米汞柱,而PAL为25毫米汞柱。在额定流量下,平均O₂和CO₂传输速率分别为101.75±10.81和77.93±8.40毫升/分钟。平均最大O₂和CO₂交换效率分别为215.75±22.93和176.99±8.40毫升/(分钟·平方米)。体内测试显示,对于1.07±0.02升/分钟的血流量,平均出口SO₂为100%,平均压降为2±0毫米汞柱。由于阻力较低,PAL-LR朝着减轻与特发性肺动脉高压相关的右心室应变的无泵人工膜肺迈出了有希望的一步。

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本文引用的文献

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Toward a Long-Term Artificial Lung.迈向长期人工肺。
ASAIO J. 2020 Aug;66(8):847-854. doi: 10.1097/MAT.0000000000001139.
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CO clearance by membrane lungs.膜肺对二氧化碳的清除
Perfusion. 2018 May;33(4):249-253. doi: 10.1177/0267659117736379. Epub 2017 Nov 1.
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A Membrane Lung Design Based on Circular Blood Flow Paths.基于圆形血流路径的膜肺设计
ASAIO J. 2017 Sep/Oct;63(5):637-643. doi: 10.1097/MAT.0000000000000616.

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