新生児用ECMO(Extracorporeal Membane Oxygenation)装置の開発及び潅流法に関する実験的研究

概要

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Twe types of ECMO units for newborn repiratory failure were developed in our laboratory. One utilizes a roller pump for venoarterial bypass (V-A bypass) or venovenous bypass of a continuous perfusion system (continuous V-V bypass). Another unit utilizes a pneumatic driving system for venovenous bypass of a to-and-fro perfusion system (to-and-fro V-V bypass) which could easily be performed by inserting a single cannula via the jugular vein. With these units, three types of bypasses were investigated experimentally by using puppies whose weights ranged from 2.5 to 5.0kg. General aneathesia was maintained with hypoventiration and ECMO was started. Hemodynamic and blood gas data were measured to evaluate the effect of ECMO. And, the three types of bypasses were performed for twelve hours to examine the effect on the liver, kidneys, lungs and blood. Conclusions were as follows : 1) Our ECMO units were safe and easily operated. 2) Hemodynamics during ECMO were stable and there were no differences between three bypass methods. 3) As to the effect on the reapiratory support, V-A bypass was most effective, but even in the to-and-fro V-V bupass, oxugen transfer of 2.4ml/kg/min was obtained with a bypass flow of 50ml/kg/min. 4) The effect on the liver, kidneys, lungs were almost none, and blood was only slghtlty damaged during twelve-hour perfusions. 5) Clinical applicasion of the to-and-fro V-V bypass is warranted.
日本小児外科学会の論文
1989-06-20