Mechanical Augmentation of the Diaphragm for End-Stage Respiratory Failure

机械增强隔膜治疗终末期呼吸衰竭

• 批准号: 10057755
• 负责人: Ellen T. Roche
• 金额: $ 60.26万
• 依托单位: MASSACHUSETTS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-17 至 2023-09-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057755
• 关键词: Abdominal Cavity; Address; Bilateral; Biological; Biomechanics; Biomimetics; Blood gas; Boston; Breathing; Cadaver; Cardiac; Chronic; Clinical; Collaborations; Complex; Data; Devices; Elastomers; Etiology; Failure; Family suidae; Fright; Functional disorder; Future; Goals; Heart; Heart failure; Hypercapnia; Hypoxemia; Image; Implant; In Situ; In Vitro; Individual; Inhalation; Lead; Left; Life Extension; Longevity; Magnetic Resonance Imaging; Measurement; Mechanical ventilation; Mechanics; Medical; Modeling; Motion; Muscle; Muscle Contraction; Muscle Weakness; Muscle function; Muscular Dystrophies; Myocardial Contraction; Neurodegenerative Disorders; Neuromuscular Diseases; Operative Surgical Procedures; Organ; Palliative Care; Paralysed; Pathologic; Patients; Pattern; Pediatric Hospitals; Performance; Physiological; Procedures; Proxy; Pump; Quality of life; Research; Respiration; Respiration Disorders; Respiratory Diaphragm; Respiratory Failure; Respiratory Muscles; Respiratory Paralysis; Respiratory physiology; Risk; Robot; Robotics; Self-Help Devices; Speech; Spirometry; Structure of phrenic nerve; Surgeon; Techniques; Technology; Testing; Therapeutic; Thoracic cavity structure; Tidal Volume; Time; Tissues; Tracheostomy procedure; Training; Translating; Transportation; Trauma; Uncertainty; Ventilator; Vital capacity; base; design; experience; experimental study; high reward; high risk; implantable device; improved; in vitro Model; in vivo; in vivo Model; iterative design; novel therapeutics; pressure; prototype; respiratory; robotic device; thoracic pressure; ventilation

Abstract Severe respiratory muscle weakness, specifically diaphragm dysfunction, can arise from many conditions, including trauma and neuromuscular disorders. Patients with diaphragm dysfunction experience respiratory failure due to “pump failure”, in which the mechanical pumping function of the respiratory muscles fail to generate the necessary motion and pressure gradients to drive respiratory ventilation, specifically inspiration. Moderate respiratory failure may be addressed with non-invasive ventilation, however if non-invasive ventilation techniques fail, invasive ventilation via tracheostomy is currently the only other option. Invasive ventilation is often declined by the patient due to the interference with quality of life. The major long-term goal of this project is to develop of an alternative therapeutic ventilation option based on medical soft robotics: an “implantable ventilator” based on augmenting diaphragm motion. We chose to use soft robotic actuators as they can interact nondestructively with biological tissues and can augment the mechanical motion of muscles. In order to achieve the overall objective we will build a pressurized benchtop testbed of the diaphragm to allow for rapid prototyping and testing as there is currently a lack of in vitro models of diaphragm biomechanics. We will iteratively design and test our device prototypes in the in vitro set up and in situ within pig cadavers to optimize device function. We will evaluate the final device within an in vivo porcine model. Such a device may provide patients with end-stage mechanical respiratory failure an alternative therapeutic option to invasive ventilation.

抽象的 严重的呼吸肌无力，特别是膈肌功能障碍，可能由多种情况引起， 包括创伤和神经肌肉疾病患者患有膈肌功能障碍。 由于“泵故障”而导致的故障，即呼吸肌的机械泵功能无法产生 驱动呼吸通气（特别是中等吸气）所需的运动和压力梯度。 呼吸衰竭可以通过无创通气来解决，但是如果无创通气技术 如果失败，通过气管切开术进行有创通气是目前唯一的选择。有创通气常常被拒绝。 该项目的主要长期目标是开发 基于医疗软机器人技术的替代治疗性通气选择：基于 我们选择使用软机器人执行器，因为它们可以与非破坏性地相互作用。 生物组织并可以增强肌肉的机械运动以实现总体目标。 我们将建造一个隔膜加压台式测试台，以便进行快速原型设计和测试 目前缺乏隔膜生物力学的体外模型，我们将迭代设计和测试我们的设备。 我们将在体外和猪尸体内建立原型，以优化设备功能。 体内猪模型中的最终装置 这种装置可以为患者提供终末期机械治疗。 呼吸衰竭是有创通气的替代治疗选择。