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用于中期血流动力学稳定的自展开主动脉外压迫装置的研发:一项可行性研究。

Development of a Self-Deploying Extra-Aortic Compression Device for Medium-Term Hemodynamic Stabilization: A Feasibility Study.

作者信息

Ji Adrienne, Davies James, Phan Phuoc Thien, Nguyen Chi Cong, Sharma Bibhu, Zhu Kefan, Nicotra Emanuele, Wan Jingjing, Phan Hoang-Phuong, Hayward Christopher, Lovell Nigel H, Do Thanh Nho

机构信息

Graduate School of Biomedical Engineering, Faculty of Engineering, and Tyree Institute of Health Engineering (IHealthE), UNSW Sydney, Kensington Campus, Sydney, NSW, 2052, Australia.

School of Mechanical and Manufacturing Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW, 2052, Australia.

出版信息

Adv Sci (Weinh). 2025 Mar;12(11):e2412120. doi: 10.1002/advs.202412120. Epub 2024 Dec 27.

DOI:10.1002/advs.202412120
PMID:39731354
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11923917/
Abstract

Hemodynamic stabilization is crucial in managing acute cardiac events, where compromised blood flow can lead to severe complications and increased mortality. Conditions like decompensated heart failure (HF) and cardiogenic shock require rapid and effective hemodynamic support. Current mechanical assistive devices, such as intra-aortic balloon pumps (IABP) and extracorporeal membrane oxygenation (ECMO), offer temporary stabilization but are limited to short-term use due to risks associated with prolonged blood contact. This research presents a novel proof-of-concept soft robotic device designed with the aim of achieving low-risk, medium-term counterpulsation therapy. The device employs a nature-inspired growing mechanism for potentially minimally invasive deployment around the ascending aorta, coupled with hydraulic artificial muscles for aortic compression. It demonstrated a maximum stroke volume of 16.48 ± 0.21 mL (SD, n = 5), outperforming all other non-pneumatic extra-aortic devices. In addition, in vitro tests with a mock circulation loop (MCL) show a drop in aortic end-diastolic pressure by 6.32 mmHg and enhance coronary flow under mild aortic stenosis, which attenuate the device's assistive effect. These findings highlight the device's strong potential for optimization as a promising solution to improve outcomes for hemodynamically unstable HF patients.

摘要

血流动力学稳定在急性心脏事件的管理中至关重要,在这些事件中,血流受损会导致严重并发症并增加死亡率。失代偿性心力衰竭(HF)和心源性休克等病症需要快速有效的血流动力学支持。当前的机械辅助装置,如主动脉内球囊泵(IABP)和体外膜肺氧合(ECMO),可提供临时稳定,但由于与长时间血液接触相关的风险,仅限于短期使用。本研究提出了一种新颖的概念验证软机器人装置,旨在实现低风险的中期反搏治疗。该装置采用受自然启发的生长机制,以便在升主动脉周围进行潜在的微创部署,并结合液压人工肌肉进行主动脉压缩。它展示出最大 stroke 容积为 16.48 ± 0.21 mL(标准差,n = 5),优于所有其他非气动主动脉外装置。此外,在模拟循环回路(MCL)上进行的体外测试表明,在轻度主动脉瓣狭窄情况下,主动脉舒张末期压力下降 6.32 mmHg,并增加冠状动脉血流量,这会减弱该装置的辅助效果。这些发现凸显了该装置作为改善血流动力学不稳定 HF 患者预后的有前景解决方案进行优化的强大潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/50b04c6a3b1b/ADVS-12-2412120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/563de3120f29/ADVS-12-2412120-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/4ae554ae07b7/ADVS-12-2412120-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/ac5b87ab4edb/ADVS-12-2412120-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/2f6dfed85fa7/ADVS-12-2412120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/2d83981863a8/ADVS-12-2412120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/50b04c6a3b1b/ADVS-12-2412120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/563de3120f29/ADVS-12-2412120-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/4ae554ae07b7/ADVS-12-2412120-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/ac5b87ab4edb/ADVS-12-2412120-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/2f6dfed85fa7/ADVS-12-2412120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/2d83981863a8/ADVS-12-2412120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9868/11923917/50b04c6a3b1b/ADVS-12-2412120-g001.jpg

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