The study of the nonpulsatile biventricular bypass method

非搏动性双心室搭桥术的研究

• 批准号: 04454347
• 负责人: KOHNO Hiroyuki
• 金额: $ 4.22万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04454347/
• 关键词: Centrifugal Biventricular bypass; Nonpulsatile Perfusion; Cardiovascular Bypass; Prostaglandin E_1; Oxygen Consumption; Intra-aortic Balloon Pumping; Renal Sympathetic Nerve Activity; Hypothermia; 無拍動潅流; 無拍動流; 体外循環; 低体温法; 補助循環

To investigate the responses of the living body under unphysiological state induced by artificial circulation with nonpulsatile blood flow, following studies have been performed.(1)The effects of pump flow rate and PGE_1 administration on oxygen use during a moderate hypothermic (29ﾟC in rectal temperature) cardiopulmonary bypass (CPB) was investigated in human. The present result suggested that the critical flow rate to maintain adequate tissue oxygenation is somewhere between 1.6 and 1.8 L/min/m^2 during moderate hypothermic CPB and that PGE_1 administration increased the oxygen consumption at a lower flow rate than the critical flow rate, probably by improving tissue level microcirculation.(2)The effects of intra-aortic balloon pumping (IABP) on renal sympathetic nerve activity (RSNA) was investigated in dogs. The renal sympathetic nerve was monitored directly and IABP was driven. IABP decreased RSNA and renal vascular resistance. Even though the renal arterial pressure decreased by IABP driving, the renal flow increased, suggesting that IABP improved the renal perfusion through the mechanism of the arterial baroreflex.(3)The effects of hypothermic CPB and profound hypothermic circulatory arrest (PHCA) on RSNA was investigated in rabbits. The body temperature (BT) was decreased by core cooling from 37ﾟC to 18ﾟC and rewarmed to 37ﾟC.RSNA and arterial baroreflex gain decreased as BT decreased, which were restored after rewarming. RSNA disappeared during PHCA but reappeared during normothermic circulatory arrest after rewarming. Thus, hypothermic CPB and PHCA suppresses RSNA.(4)To establish chronic nonpulsatile blood flow (NPBF) animal model, the centrifugal biventricular bypass was implanted in 9 goats. Six out of 9 animals survived over 2 days, however, no animal survived over 7 days. Goats seemed to be not suitable for chronic NPBF animal model.

为了研究生物在非生理学状态下通过人工循环引起的无脉冲血液流动的反应。目前的结果表明，在中等温度的CPB中，维持足够的组织氧合的临界流量在1.6至1.8 l/min/m^2之间，并且PGE_1给药增加了比临界流量低的流量的氧气消耗，而不是临界流量的氧气消耗，这可能是通过改善静脉内的（2）置式（2）intraimiage sulta-apter sulta-a-a-apter nriak nriak nriak onerain perniag onerain-a-a-a-a-a-airic of Antronic of Antronic Ballniain（R）（R）（R）（R）（r）（R）（R）（R）（R）（R）（R）（R）（R）。在狗中进行了调查。直接监测肾交感神经，并驱动IABP。 IABP降低了RSNA和肾血管耐药性。即使IABP驾驶肾动脉压降低，肾脏流量也会增加，这表明IABP通过动脉降压的机制改善了肾脏灌注。通过核心冷却从37°C降低至18°C，体温（BT）降低，并加热到37 c.rsna，而动脉压力反射随着BT的降低而降低，重新升温后恢复了BT。 RSNA在PHCA期间消失了，但在重新传输后在近温度电路停滞期间重新出现。低温CPB和PHCA抑制了RSNA。（4）为了建立慢性非脉动血流（NPBF）动物模型，将离心双脑室旁路植入了9只山羊。但是，有9只动物中有六个存活了2天，但是没有动物在7天内存活。山羊似乎不适合慢性NPBF动物模型。

项目成果

Tominaga R: "Effects of pump flow rate on oxygen utilization during moderate hypothermic cardiopulmonary bypass." ASAIO Journal. 39. 126-131 (1993)

Tominaga R：“中度低温体外循环期间泵流量对氧气利用的影响。”

Tominaga R: "Effects of pump flow rate on oxygen utilization during moderate hypothermic cardio-pulmonary bypass." ASAIO journal. 39. 126-131 (1993)

Tominaga R：“中度低温心肺转流期间泵流量对氧气利用率的影响。”

富永隆治、徳永皓一: "心臓血管外科領域における最近の医療機器:ヘパリンコーティング人工心肺回路" 学会新報. 14. 5-15 (1993)

Ryuji Tominaga、Koichi Tokunaga：“心血管外科领域的最新医疗设备：肝素涂层心肺旁路回路”学会公报 14. 5-15 (1993)。

中島淳博: "左心補助施行時の右心機能に対するPEEPの影響" 人工臓器. 22(3). 600-604 (1993)

Atsuhiro Nakajima：“左心室辅助期间 PEEP 对右心功能的影响”人工器官 22(3)。

Nakashima A: "Effect of positive-end expiratory pressure (PEEP) on right ventricular function during left heart bypass. (in Japanese)" The Japanese Journal of Artificial Organs. 22(3). 600-604 (1993)

Nakashima A：“左心搭桥期间呼气末正压 (PEEP) 对右心室功能的影响。（日语）”《日本人工器官杂志》。