|Budget Amount *help
¥3,800,000 (Direct Cost : ¥3,800,000)
Fiscal Year 1997 : ¥1,700,000 (Direct Cost : ¥1,700,000)
Fiscal Year 1996 : ¥2,100,000 (Direct Cost : ¥2,100,000)
To make the neonatal extracorporeal mambrane oxygenation (ECMO) management less laborious and safer, we have been investigating automatic control of the ECMO apparatus. In this study, we modified the ECMO system using Takagi's self-regulating blood pumps for the clinical use. The newest blood pump consists of a pair of tube-type blood chambers, modified ball valves, housings for driving air, and photosensors. Blood chambers and valves are disposable at low prices. The newest driving and control machine, which was modified from the ready-made ventricular assist device, possesses three modes of drive, " Automatic", "Delay", and "Constant". The "Automatic" mode is used when ECMO runs at a maximum bypass flow, and the "Constant" mode for a low bypass flow when ECMO is withdrawn. The "Delay" mode enables ECMO flow to change easily from 10 to 450 ml/min under automatic control, and used when an ECMO flow is gradually decreased for weaning. This driving machine is battery-driven as well and portable, and it is possible that a moribund child can be transported as he/she is under ECMO support. The performance of the newest pump systems was investigated on a simulation circuit and by using animals. This new ECMO circuit was clinically used in 2 neonates, one having huge-sized CCAM of the left lung and another congenital diaphragmatic hernia, with the ECMO duration being 142 to 168 hours. Both children were successfully weaned from ECMO and one survived without any sequelae. Because our blood pump systems enable to change the ECMO flow automatically in response to hemodynamics, it is not necessary to observe the ECMO pump incessantly nor to infuse blood materials only for the purpose of stabilizing the pump performance. Injury to blood cells was significantly less, therefore, platelet was not transfused during the ECMO course in one patient with CCAM.Our ECMO circuit required less personnel and was favorable for hematological findings.