Real-time cardiopulmonary perfusion monitoring system

实时心肺灌注监测系统

• 批准号: 6790753
• 负责人: CHRISTOPHER S LUCCI
• 金额: $ 9.95万
• 依托单位: ENSION, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-22 至 2006-03-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6790753
• 关键词: animal tissue; bioengineering /biomedical engineering; biomedical equipment development; carbon dioxide tension; circulatory assist; clinical biomedical equipment; computer program /software; evaluation /testing; extracorporeal circulation; heart /lung bypass; mathematical model; noninvasive diagnosis; oxygen tension; patient safety /medical error; perfusion; respiratory gas analyzer; time resolved data

DESCRIPTION (provided by applicant): Discrete arterial blood gas measurement (ABG) remains as the "gold standard" used by perfusionists to ascertain the effectiveness of their ability to maintain homeostasis during cardiopulmonary bypass. There are two major problems with this practice; ABG only measure one point in a continuing process and in today's environment of cost reduction, the cost associated with each determination, hence long intervals between measurements. One specific example of a commonly occurring condition where ABG is not reliable follows rewarming of pediatric patients during cardiopulmonary bypass. In this situation ABG appear normal, but in fact as tissues rewarm they frequently "release" accumulated CO2 (formed during periods of hypoperfusion), which can first be measured internally by complex tissue tonometry or by increased CO2 in the oxygenator exhaust gas. This differential condition, where tissue CO2 is higher than arterial CO2 is known as "pCO2 gap". The proposed instrument measures this parameter and gives perfusionists early warning that the level of support maybe inadequate. Ension is proposing to develop a gas measurement system that would measure oxygen and carbon dioxide concentrations in blood oxygenator exhaust gas. This system would mitigate the two concerns expressed above. It would be continuous, logging data at intervals as short as one second, thus giving the perfusionist continuous information regarding the adequacy of perfusion. This device would be relatively low-cost and could obviate the need for frequent blood gas measurement. We propose both in vitro testing in our laboratory and ex vivo evaluation at Children's Hospital in Pittsburgh to develop our hardware and algorithms. Preapplication concept evaluation under clinical conditions has demonstrated that large amounts of carbon dioxide, at levels higher than expected, can be present and can be accurately measured in the blood oxygenator exhaust gas. Anecdotally, patients who do not experience this CO2 gap seem to have smoother and faster recoveries.

描述（由申请人提供）： 离散的动脉血液测量（ABG）仍然是灌注者用来确定其在心肺旁路期间维持体内平衡能力的有效性的“金标准”。这种做法有两个主要问题。 ABG仅在持续的过程中以及当今降低成本的环境，与每个确定相关的成本，因此测量之间的间隔很长的时间。在心肺旁路期间，小儿患者的重新传输后，通常发生ABG不可靠的情况下，ABG不可靠的一个具体例子。在这种情况下，ABG看起来很正常，但实际上，随着组织的重新传输，它们经常“释放”累积的二氧化碳（在灌注灌注期间形成），可以首先通过复杂的组织Tonometry或增加氧化剂排气气中的二氧化碳内部测量。这种差异条件，其中组织二氧化碳高于动脉二氧化碳被称为“ PCO2 GAP”。拟议的仪器衡量了该参数，并为灌注者提供了早期警告，即支持水平可能不足。 Resion提议开发一种气体测量系统，该系统将测量血氧氧合排气气中的氧气和二氧化碳浓度。该系统将减轻上述两个问题。这将是连续的，以一秒钟的时间间隔记录数据，从而提供了有关灌注充足性的灌注者的连续信息。该设备的成本相对较低，可能会消除经常进行血液气体测量的需求。我们建议在实验室中进行体外测试，并在匹兹堡儿童医院进行过体内评估，以开发我们的硬件和算法。临床条件下的预涂概念评估表明，可以存在的水平高于预期的水平，并且可以在血液氧化剂排气气中进行准确测量。有趣的是，没有经历此二氧化碳差距的患者似乎更加顺畅，恢复速度更快。