1989 Fiscal Year Final Research Report Summary
SAFETY AND EFFICACY OF A PROLONGED EXTRACORPOREAL LUNG ASSIST WITH A HEPARIN BONDED ARTIFICIAL MEMBRANE LUNG.
| Project/Area Number |
63480351
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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, MEDICAL SCHOOL, ASSOC PRO., 医学部, 助教授 (30040562)
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| Co-Investigator(Kenkyū-buntansha) |
HASHIGUCHI Akira KUMAMOTO UNIVERSITY, MEDICAL SCHOOL, ASSISTANT, 医学部附属病院, 助手 (10180811)
EZAKI Kimiaki KUMAMOTO UNIVERSITY, MEDICAL SCHOOL, ASSISTANT, 医学部附属病院, 助手 (80151976)
TAKESHITA Jiro KUMAMOTO UNIVERSITY, MEDICAL SCHOOL, ASSISTANT, 医学部附属病院, 助手 (60171633)
OTSU Tetsuro KUMAMOTO UNIVERSITY, MEDICAL SCHOOL, ASSISTANT, 医学部附属病院, 助手 (40152178)
OKAMOTO Kazufumi KUMAMOTO UNIVERSITY, MEDICAL SCHOOL, INSTRUCTOR, 医学部附属病院, 講師 (60093994)
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| Project Period (FY) |
1988 – 1989
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| Keywords | Artificial membrane lung / Heparin bonding / Antithrombogenecity / Prolonged extracorporeal circulation / ECLA / Respiratory failure |
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| Research Abstract |
ANIMAL STUDY: We investigated safety and blood compatibility of a prolonged veno-venous extracorporeal lung assist (ECLA) with a heparin bonded artificial membrane lung and circuit (CARMEDA, SWEDEN ) in 18 goats. ECLA was performed with a non-heparin bonded lung in group I , a heparin bonded lung resterilized by ethylene oxide gas in group II, a heparin bonded lung in groupIII . Activated coagulation time was maintained about 200 seconds in group I , 120- 130 seconds in group II, III by continuous infusion of a small amount of heparin solution.
An average of bypass blood flow and bypass duration were 46.0ml/Kg/min., 6.7 days in group I, 36.5ml/Kg/min., 7.8 days in group II, 41.3ml/Kg/min., 7.8 days in group III. A mean dose of heparin administered was 26 units /Kg/hr. in group I, 17 units/Kg/min. in group II, 14 units/Kg/hr. in group III . The dose of heparin in group II , III were less significantly ( p < 0.05) than in group I. Among three groups, there were no large difference in platelet-coagulation system except fibrionpeptide A which increased significantly ( p < 0.05) in group n compared with group III. A reexposure of a heparin bonded membrane lung to ethylene oxide gas may decrease antithrombogenecity, however, the heparin bonded surface provides excellent blood compatibility during a prolonged ECLA.
CLINICAL STUDY :We applied prolonged extra corporeal lung and heart assist (ECLHA ) with a heparin bonded membrane lung for six patients with severe cardiopulmonary failure following an open heart surgery. Blood loss decreased to less than 1/10 of that in our previous cases with a non-heparin bonded lung. Three of these patients were successfully weaned from ECLHA on the 5th, 6th, and 2nd day. The heparin bonding of an artificial membrane lung and a circuit will afford a safer ECLA (ECLHA ) for a patient even with fresh and multiple wounds.
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