1993 Fiscal Year Final Research Report Summary
Fundamental and Clinical Study to Establish Indications and the Safety of a Life Support System with an Artificial Lung
| Project/Area Number |
04454390
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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 SCHOOL OF MEDICINE |
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Principal Investigator |
MORIOKA Tohru Kumamoto University School of Medicine, Dept of Anesthesiology Professor, 医学部, 教授 (30040140)
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| Co-Investigator(Kenkyū-buntansha) |
USHIJIMA Kazuo Kumamoto University School of Medicine, Dept of Anesthesiology Ihstructor, 医学部附属病院, 講師 (60136752)
TERASAKI Hidenori Kumamoto University School of Medicine, Dept of Anesthesiology Associate Profess, 医学部, 助教授 (30040562)
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| Project Period (FY) |
1992 – 1993
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| Keywords | Artificial Heart Lung Machine / Membrane Lung / Life Support / Indications / ECLS / Anticoagulant / Instrumentation / Extracorporeal Circulation |
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| Research Abstract |
The life support system with an artificial heart-lung machine, which we call ECLS instead of ECMO, has becom more and more popular. Various research societies have been established for the study of this new modality of medicine. However. indications of ECLS have not been well established. Though there are standards or entry criteria for ECMO, they only indicate critical conditions with a survival expectancy of less than 10%. They do not necessarily represent the indications for ECLS.
We have improved various bypass methods and instruments for facility and safety of ECLS.
They include the artificial hollow fiber lung, quick connectors, blood accesses, pressure control devices, automating mechanics of bypass circulation according to the blood volume in the reservoir, etc. Bypass circulation is continued for several days without difficulty after improvement with such devices. Blood loss has been markedly decreased by applying nafamostat mesilate instead of heparin. The safety of the prolonged use of this drug was confirmed by animal experiments and clinical application of the drug.
We have had 59 cases of ECLS with a survival rate of about 50%. Though this ratio is not large enough, these patients were saved from a critical condition where their life expectancy was almost zero even under maximal conventional ventilation.
With this experience, we established indications for ECLS, published them in several journals and presented them for discussion in many conferences on ECLS held in various countries. The life support with an extracorporeal bypass system will become an important new field of medicine in the next decade.
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