Tajiri A, Terasaki H, Morioka T
Department of Anesthesiology, Kumamoto University School of Medicine.
Masui. 1993 Oct;42(10):1536-40.
We improved our manually operated cardiopulmonary bypass circuit by adding another reservoir-pump in parallel to continue the venous blood withdrawal. The two reservoir-pumps were alternately and maximally compressed by hand, and hydrodynamics of the device was examined in vitro by using a physiological saline solution. When a 21 Fr, 52 cm catheter for venous drainage and a 17 Fr, 17 cm catheter for arterial infusion were used, the bypass flow rate was about 2.1 l.min-1 even under no waterhead. It was further increased to about 3.1 l.min-1 by adding a head of 60 cmH2O. The upper body of a patient undergoing resuscitation is occupied by other personnel performing mandatory procedures such as cardiac massage and endotracheal intubation. Therefore, the catheter insertion site is limited to the femoral vessels, and a long arterial return catheter will be necessary for a better cerebral oxygen supply. When a 17 Fr long arterial return catheter with 52 cm in length was used, the maximal flow rate achieved about 2.8 l.min-1 under a head of 60 cmH2O, though slightly smaller than that with the 17 cm catheter. This double reservoir-pump circuit with a long arterial return catheter will facilitate emergency cardiopulmonary bypass during acute critical resuscitation and much improve the perfusion to the vital organs.
我们通过并联增加另一个储液泵来改进手动体外循环回路，以持续抽取静脉血。两个储液泵由手交替且最大程度地挤压，并使用生理盐水在体外检查该装置的流体动力学。当使用一根21 Fr、52 cm的静脉引流导管和一根17 Fr、17 cm的动脉灌注导管时，即使在没有水头的情况下，旁路流速约为2.1 l·min⁻¹。通过增加60 cmH₂O的水头，流速进一步提高到约3.1 l·min⁻¹。接受复苏的患者上半身被进行心脏按压和气管插管等强制操作的其他人员占据。因此，导管插入部位限于股血管，并且为了更好地供应脑氧，需要一根长的动脉回流导管。当使用一根17 Fr、长52 cm的动脉回流导管时，在60 cmH₂O的水头下，最大流速达到约2.8 l·min⁻¹，尽管略小于使用17 cm导管时的流速。这种带有长动脉回流导管的双储液泵回路将有助于急性重症复苏期间的紧急体外循环，并大大改善对重要器官的灌注。
