Feasibility study of an artificial placenta system with looped ECMO circuit for neonatal respiratory disorders

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K21915
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Review Section: Medium-sized Section 90:Biomedical engineering and related fields
• Research Institution: National Cardiovascular Center Research Institute
• Principal Investigator: MIZUNO Toshihide 国立研究開発法人国立循環器病研究センター, 研究所, 室長 (40426515)
• Co-Investigator(Kenkyū-buntansha): 西中 知博 国立研究開発法人国立循環器病研究センター, 研究所, 部長 (00256570) ; 稲富 絢子 国立研究開発法人国立循環器病研究センター, 研究所, 流動研究員 (40823464)
• Project Period (FY): 2020-07-30 – 2022-03-31
• Keywords: 人工胎盤 / ECMO / 胎児循環 / ガス交換

Outline of Final Research Achievements

We have developed a new artificial placenta (AP) system consisting of a looped ECMO circuit bridging to the fetus circulation in the form of an umbilical arterial-venous connection. We aimed to evaluate the feasibility of the AP system by performing a hydrodynamic experiment of simulation using a mechanical mock circulation system and a fetal animal experiment. This simulation showed that in an AP system with an ECMO in series between the umbilical arteries and vein, it was difficult to maintain fetal hemodynamics when high ECMO flow was applied. The AP system consisting of the loop circuit configuration ECMO with a bridge circuit could have high ECMO flow with less umbilical flow, whereas the possibility of excessive load on the fetal right ventricular system should be noted. In the animal experiment, GA135 days kid was maintained for 12 days and grew to term. The developed AP system was feasible under both in vitro and in vivo conditions.

Free Research Field

人工臓器学

Academic Significance and Societal Importance of the Research Achievements

近年の新生児医療の発展による治療成績の向上は目覚ましいが，超低出生体重児における慢性肺疾患の罹患率は未だに高く，新生児救命の新たな治療法の開発は喫緊の課題である．我々が開発を行っている人工胎盤システムは，抗血栓性に優れた膜型人工肺と血液ポンプをループ状に配置したECMO回路を臍帯動脈と静脈の間にブリッジするようにデザインされ，ECMO回路をループ循環する血流量を十分に確保しつつ，胎児循環への血流量を適切な範囲に保つことことが可能である．将来的には，本システムを早産児および重症呼吸障害児に適応し，人工呼吸器管理による肺損傷を回避した長期呼吸循環管理の実現を目指している．