| Project/Area Number |
01870055
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| Research Category |
Grant-in-Aid for Developmental Scientific Research (B).
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| Allocation Type | Single-year Grants |
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| Research Field |
General surgery
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| Research Institution | Osaka University |
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Principal Investigator |
OKADA Akira Osaka University Medical School, Dept. of Pediatric Surgery, Professor., 医学部, 教授 (40028569)
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| Co-Investigator(Kenkyū-buntansha) |
FUKUI Yuichi Osaka University Medical School, Dept. of Pediatric Surgery, Assistant Professor, 医学部, 助手 (30218896)
KAMATA Shinkichi Osaka University Medical School, Dept. of Pediatric Surgery, Assistant Professor, 医学部, 助手 (40161202)
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| Project Period (FY) |
1989 – 1991
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| Project Status |
Completed (Fiscal Year 1991)
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| Budget Amount *help |
¥10,100,000 (Direct Cost: ¥10,100,000)
Fiscal Year 1991: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1990: ¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1989: ¥7,400,000 (Direct Cost: ¥7,400,000)
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| Keywords | Extracorporeal Membrane Oxygenation (ECMO) / Pulsatile Flow / Counterpulsation / Endotoxic / Shock / 拡張期カウンタ-パルセイション / 拍動流ECMO / 新生児 / ECMO(呼吸補助) / 拍動流体外循環法 |
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| Research Abstract |
We designed a synchronous pulsatile V-A ECMO device for neonates to accomplish more effective circulatory support. The effect of this device was studied in an endotoxin-induced shock model, compared with conventional nonpulsatile V-A ECMO.
1. Synchronous pulsatile ECMO system
This system consists of the conventional V-A ECMO circuit a 6.0 ml balloon in the arterial line as a counterpulsator. This balloon is specially designed for neonates and is driven with an electrocardiogram triggering mechanism. In a preliminary experimental study using puppies, blood pressure, renal blood flow and urinary output were significantly higher during pulsatile ECMO than nonpulsatile ECMO.
2. Effects of pulsatile ECMO in an endotoxin shock model
Twenty puppies weighing 1.6 to 4.0 kg were given endotoxin (5mg/kg) intravenously. Thirty minutes after the administration of endotoxin, ten of those were placed on pulsatile ECMO, and the others were placed on nonpulsatile ECMO. All of the animals were studied for additional 180 minutes. Low blood pressure, reduced renal blood flow and progressive metabolic acidosis were demonstrated in nonpulsatile ECMO. On the other hand, blood pressure and renal blood flow were well maintained, and metabolic acidosis was improved in pulsatile ECMO. There were no significant difference in the serum free hemoglobin levels between pulsatile and nonpulsatile ECMO.
3. Conclusion
These results indicate that pulsatile ECMO may provide effective cardiopulmonary support in the treatment of neonates with serious circulatory failure which has been failed to support by nonpulsatile ECMO.
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