1992 Fiscal Year Final Research Report Summary
Safety and validity of the small heparin-bonded artificial membrance lung for neonatal extracorporeal lung assist.
| Project/Area Number |
03454378
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
麻酔学
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| Research Institution | KUMAMOTO UNIVERSITY |
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Principal Investigator |
TERASAKI Hidenori KUMAMOTO UNIVERSITY, ANESTHESIOLOGY, ASSOCIATE PROFESSOR, 医学部, 助教授 (30040562)
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| Co-Investigator(Kenkyū-buntansha) |
TAJIRI Akihiko KUMAMOTO UNIVERSITY, ANESTHESIOLOGY, ASSISTANT, 医学部, 助手 (50236527)
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| Project Period (FY) |
1991 – 1992
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| Keywords | ARTIFICIAL MEMBRANE LUNG / ANTITHROMBOGENECITY / HEPARIN / HEPARIN-BONDED MEMBRANE LUNG / EXTRACORPOREAL LUNG ASSIST / 出血防止 / ヤギ |
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| Research Abstract |
We present the results of our fundamental animal studies and clinical experiences in extracorporeal lung assist (ECLA) with the artificial membrane lung. A new type of heparin-bonded dense membrane lung, which we constructed, reduced the systemic requirement of heparin to less than half of the conventional dose in ECLA on goats. This heparin-bonded circuit was applied to ECLA for patients with active bleeding sites, and could save them from severe cardio-pulmonary failure refractory to conventional treatments. As another approach to prevent bleeding attributable to impaired blood coagulation with heparin, we administered Nafamostat mesilate (FUT) as a substitute for heparin during ECLA on dogs. A large amount of FUT, 7.3*0.8 mg/kg/hr (mean * SD, n = 7), enabled safer ECLA. To simplify the ECLA maneuver in emergency, we devised a pre-primed ECLA circuit that was manually driven without using electric power. A pre-primed lung, stored for one year, provided a good function of gas exchange. The total number of ECLA patients in Kumamoto University Hospital has been 52 up to March 1993. Of the 52 patients who underwent ECLA, 29 patients underwent respiratory support, and 23 patients circulatory support. The survival rate on two months after weaning from ECLA was 46%. ECLA will become a new promising method in critical care medicine.
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