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Michael Shaw1, Nigel Cross1, Rebecca Richardson1
1Perfusion Department, Great Ormond Street Hospital for Children, London, UK.
身体外膜氧化 (ECMO) 氧化器可以安全地超过2:1的气体:血液流速比. 这项研究没有发现气体压力或微栓塞的显著增加,确保了关键治疗期间的患者安全.
科学领域:
- 生物医学工程 生物医学工程
- 支持心肺血管的支持.
- 儿科重症监护 儿科重症监护
背景情况:
- 身体外膜氧化 (ECMO) 需要氧化器来处理儿科患者的不同流速.
- 标准ECMO氧化器的最大气体:血液流速 (GBFR) 比率为 2:1,但可能需要更高的比率来充分去除CO2.
- 超过GBFR比率可以理论上增加气相压力,可能导致气状微栓塞 (GME) 和神经损伤.
研究的目的:
- 为了评估气相压力和儿童和成人ECMO氧化器中的GME释放,在GBFR比率超过2:1的情况下.
- 为了确定不同气体流速和氧度对氧化器性能和安全的影响.
主要方法:
- 六个儿童和六个成人A.L.ONETM ECMO氧化器在体外环境中进行了测试.
- 气相压力和GME释放在一系列GBFR比率 (高达>2:1) 中进行了评估.
- 测试是在1-10L/min的气体流速和50%和100%的F_iO2进行的.
主要成果:
- 在儿童或成人氧化器中,没有观察到气相压力超过10 mmHg的GBFR>= 2:1.
- 随着时间的推移,发现了膜后GME释放的轻微增加,但没有受到F_iO2或气体流速的显著影响.
- 在两种类型的氧化器中,最大GME体积保持在6μL以下.
结论:
- 在儿科ECMO氧化器中增加GBFR超过2:1,在成人氧化器中增加到2:1,在体外测试中并没有显著提高气相压力.
- 氧化器膜没有破裂,GME产量与气体流速没有关联.
- 这些发现表明,目前的ECMO氧化器可以在比通常建议的更高的GBFR比率下安全运行,而不会影响气体压力或GME形成的安全性.
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