Ambulatory Assist Lung for Children

儿童流动辅助肺

• 批准号: 9410956
• 负责人: William J. Federspiel
• 金额: $ 73.46万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-01-15 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410956
• 关键词: Acute; Adult; Animals; Biocompatible Materials; Biomedical Engineering; Blood; Blood gas; Cannulas; Cause of Death; Cessation of life; Child; Childhood; Chronic; Chronic lung disease; Clinical; Computer Simulation; Cystic Fibrosis; Data; Development; Devices; Environment; Extracorporeal Membrane Oxygenation; Failure; Gases; Heart; Hemolysis; Hospitalization; Hospitals; Hour; Incidence; Lead; Life; Liquid substance; Lung; Lung Transplantation; Lung diseases; Mechanical ventilation; Metabolic; Modeling; Nature; Organ Donor; Outcome; Oxygenators; Pathway interactions; Patients; Performance; Polymers; Population; Procedures; Process; Pulmonary Fibrosis; Pulmonary Hypertension; Pulmonary artery structure; Pump; Pump lung; Recovery; Right atrial structure; Surgeon; System; Testing; Tissue Engineering; Transplantation; Waiting Lists; artificial lung; blood oxygenator; blood pump; cardiopulmonary system; cystic fibrosis patients; design; experience; implantation; improved; improved outcome; in vivo; novel; patient mobility; pediatric patients; prototype; public health relevance; respiratory; respiratory assist; tool

Acute and chronic lung diseases remain the most life threatening causes of death and hospitalization in the pediatric population. Cystic fibrosis (CF), pulmonary hypertension and pulmonary fibrosis have been observed to be the most frequent causes of lung failure in pediatric patients. Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) have been used to bridge sick kids to transplant. These procedures can lead to poor post-transplant outcomes by their very restrictive nature on mobility. This project will develop a compact respiratory assist device for pediatric patients, the Pittsburgh Pediatric Ambulatory Lung (P-PAL) to replace ECMO as a bridge to transplant or recovery in kids with acute and chronic lung failure. The P-PAL is a wearable and fully integrated blood pump and gas exchange module that will be designed for implantation of inflow cannula and outflow cannula/grafts in the right atrium and pulmonary artery, respectively. The P-PAL will be designed for longer-term respiratory support (1-3 months before cartridge change-out) at 70- 90% of normal metabolic oxygenation requirements, while pumping blood from 1 to 2.5 Liters/min. The specific aims of project are 1) To modify the design and operational parameters of the P-PAL to meet requirements for blood pumping, gas exchange, priming volume, and form factor, 2) To build P-PAL prototypes along the design development pathway for bench characterization studies of pumping performance, gas exchange, and hemolysis, 3) To improve the hemocompatibility of the P-PAL by exploiting novel polymeric zwitterionic coatings that we have already begun to develop for our adult wearable assist lung, and 4) To perform acute and chronic studies in healthy lambs to demonstrate the in-vivo performance and hemocompatibility of the PAAL device and to study its interaction with the cardiopulmonary system.

急性和慢性肺部疾病仍然是导致死亡和住院的最威胁生命的原因 儿科人群。已观察到囊性纤维化（CF）、肺动脉高压和肺纤维化 是儿科患者肺衰竭的最常见原因。机械通气 (MV) 和 体外膜肺氧合（ECMO）已被用来为患病儿童和移植做好准备。这些 由于其对活动性的严格限制，手术可能会导致移植后结果不佳。这个项目 将为儿科患者开发一种紧凑型呼吸辅助设备，匹兹堡小儿动态肺 (P-PAL) 取代 ECMO 作为急性和慢性肺衰竭儿童移植或康复的桥梁。这 P-PAL 是一款可穿戴且完全集成的血泵和气体交换模块，专为 分别在右心房和肺动脉中植入流入插管和流出插管/移植物。 P-PAL 设计用于在 70 ℃ 的温度下提供长期呼吸支持（更换滤筒前 1-3 个月）。 正常代谢氧合需求的 90%，同时泵血速度为 1 至 2.5 升/分钟。具体的 项目的目标是 1) 修改 P-PAL 的设计和运行参数以满足以下要求 血液泵送、气体交换、预充量和外形尺寸，2) 按照设计构建 P-PAL 原型 泵送性能、气体交换和气体交换的台架表征研究的开发途径 溶血，3) 通过开发新型聚合物两性离子来改善 P-PAL 的血液相容性 我们已经开始为成人可穿戴辅助肺开发涂层，以及 4) 执行急性 以及对健康羔羊的长期研究，以证明其体内性能和血液相容性 PAAL 装置并研究其与心肺系统的相互作用。