SAFETY AND EFFICACY OF A PROLONGED EXTRACORPOREAL LUNG ASSIST WITH A HEPARIN BONDED ARTIFICIAL MEMBRANE LUNG.

使用肝素粘合人工膜肺进行长时间体外肺辅助的安全性和有效性。

基本信息

批准号：
63480351
负责人：
TERASAKI Hidenori
金额：
$ 4.16万
依托单位：
KUMAMOTO 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：
1988
资助国家：
日本
起止时间：
1988 至 1989
项目状态：
已结题

项目摘要

ANIMAL STUDY: We investigated safety and blood compatibility of a prolonged veno-venous extracorporeal lung assist (ECLA) with a heparin bonded artificial membrane lung and circuit (CARMEDA, SWEDEN ) in 18 goats. ECLA was performed with a non-heparin bonded lung in group I , a heparin bonded lung resterilized by ethylene oxide gas in group II, a heparin bonded lung in groupIII . Activated coagulation time was maintained about 200 seconds in group I , 120- 130 seconds in group II, III by continuous infusion of a small amount of heparin solution.An average of bypass blood flow and bypass duration were 46.0ml/Kg/min., 6.7 days in group I, 36.5ml/Kg/min., 7.8 days in group II, 41.3ml/Kg/min., 7.8 days in group III. A mean dose of heparin administered was 26 units /Kg/hr. in group I, 17 units/Kg/min. in group II, 14 units/Kg/hr. in group III . The dose of heparin in group II , III were less significantly ( p < 0.05) than in group I. Among three groups, there were no large difference in platelet-coagulation system except fibrionpeptide A which increased significantly ( p < 0.05) in group n compared with group III. A reexposure of a heparin bonded membrane lung to ethylene oxide gas may decrease antithrombogenecity, however, the heparin bonded surface provides excellent blood compatibility during a prolonged ECLA.CLINICAL STUDY :We applied prolonged extra corporeal lung and heart assist (ECLHA ) with a heparin bonded membrane lung for six patients with severe cardiopulmonary failure following an open heart surgery. Blood loss decreased to less than 1/10 of that in our previous cases with a non-heparin bonded lung. Three of these patients were successfully weaned from ECLHA on the 5th, 6th, and 2nd day. The heparin bonding of an artificial membrane lung and a circuit will afford a safer ECLA (ECLHA ) for a patient even with fresh and multiple wounds.

动物研究：我们在 18 只山羊身上研究了带有肝素粘合人工膜肺和回路（CARMEDA，瑞典）的长期静脉-静脉体外肺辅助 (ECLA) 的安全性和血液相容性。 ECLA 在第 I 组中使用非肝素结合肺进行，在第 II 组中使用经过环氧乙烷气体再灭菌的肝素结合肺进行，在第 III 组中使用肝素结合肺进行。通过持续输注少量肝素溶液，I组活化凝血时间维持在200秒左右，II、III组维持在120-130秒。旁路血流量和旁路持续时间平均为46.0ml/Kg/min。 I组6.7天，36.5ml/Kg/min.，II组7.8天，41.3ml/Kg/min.，第三组 7.8 天。施用的肝素的平均剂量为26单位/Kg/hr。第一组，17 单位/公斤/分钟。第二组，14 单位/公斤/小时。在第三组。 II、III组肝素用量较I组显着减少（p < 0.05）。三组间，除纤维蛋白肽A在n组显着增加（p < 0.05）外，三组间血小板凝血系统无明显差异。与Ⅲ组相比。肝素结合的膜肺再次暴露于环氧乙烷气体可能会降低抗血栓形成性，但是，肝素结合的表面在长时间的 ECLA 期间提供了出色的血液相容性。临床研究：我们应用了肝素结合的长期体外肺和心脏辅助 (ECLHA)为六名心脏直视手术后出现严重心肺衰竭的患者提供膜肺。失血量减少到我们之前使用非肝素肺的病例中的 1/10 以下。其中 3 名患者在第 5、6 和 2 天成功脱离 ECLHA。人工膜肺和回路的肝素粘合将为患者提供更安全的 ECLA (ECLHA)，即使患者有新伤口和多处伤口。