CN113456917A - 用于预防下肢缺血的体外膜肺氧合装置 - Google Patents
用于预防下肢缺血的体外膜肺氧合装置 Download PDFInfo
- Publication number
- CN113456917A CN113456917A CN202110755491.0A CN202110755491A CN113456917A CN 113456917 A CN113456917 A CN 113456917A CN 202110755491 A CN202110755491 A CN 202110755491A CN 113456917 A CN113456917 A CN 113456917A
- Authority
- CN
- China
- Prior art keywords
- ecmo
- pipeline
- blood
- crrt
- venous
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 239000012528 membrane Substances 0.000 title claims abstract description 22
- 210000004072 lung Anatomy 0.000 title claims abstract description 19
- 210000003141 lower extremity Anatomy 0.000 title claims abstract description 18
- 201000002818 limb ischemia Diseases 0.000 title abstract description 15
- 238000006213 oxygenation reaction Methods 0.000 title abstract description 13
- 239000008280 blood Substances 0.000 claims abstract description 48
- 210000004369 blood Anatomy 0.000 claims abstract description 48
- 238000000746 purification Methods 0.000 claims abstract description 23
- 230000002093 peripheral effect Effects 0.000 claims abstract description 18
- 230000004087 circulation Effects 0.000 claims abstract description 16
- 230000010412 perfusion Effects 0.000 claims abstract description 16
- 210000001367 artery Anatomy 0.000 claims abstract description 8
- 210000003462 vein Anatomy 0.000 claims abstract description 8
- 238000002618 extracorporeal membrane oxygenation Methods 0.000 claims abstract 17
- 238000002560 therapeutic procedure Methods 0.000 claims description 6
- 208000028867 ischemia Diseases 0.000 claims description 5
- 230000036770 blood supply Effects 0.000 abstract description 4
- 230000007547 defect Effects 0.000 abstract description 2
- 210000001105 femoral artery Anatomy 0.000 description 8
- 230000001225 therapeutic effect Effects 0.000 description 6
- 238000000034 method Methods 0.000 description 5
- 230000002792 vascular Effects 0.000 description 5
- 208000032843 Hemorrhage Diseases 0.000 description 4
- 208000034158 bleeding Diseases 0.000 description 4
- 230000000740 bleeding effect Effects 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 4
- 210000003414 extremity Anatomy 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 230000002685 pulmonary effect Effects 0.000 description 3
- 208000009304 Acute Kidney Injury Diseases 0.000 description 2
- 208000033626 Renal failure acute Diseases 0.000 description 2
- 201000011040 acute kidney failure Diseases 0.000 description 2
- 210000004204 blood vessel Anatomy 0.000 description 2
- 230000002265 prevention Effects 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 206010019280 Heart failures Diseases 0.000 description 1
- 208000010718 Multiple Organ Failure Diseases 0.000 description 1
- 208000004756 Respiratory Insufficiency Diseases 0.000 description 1
- 206010039020 Rhabdomyolysis Diseases 0.000 description 1
- 206010049418 Sudden Cardiac Death Diseases 0.000 description 1
- 206010051379 Systemic Inflammatory Response Syndrome Diseases 0.000 description 1
- 210000000709 aorta Anatomy 0.000 description 1
- 230000008321 arterial blood flow Effects 0.000 description 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 206010007625 cardiogenic shock Diseases 0.000 description 1
- 230000002612 cardiopulmonary effect Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 230000002427 irreversible effect Effects 0.000 description 1
- 230000000302 ischemic effect Effects 0.000 description 1
- 238000011542 limb amputation Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 208000029744 multiple organ dysfunction syndrome Diseases 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 230000001338 necrotic effect Effects 0.000 description 1
- 229910052760 oxygen Inorganic materials 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
- 230000002085 persistent effect Effects 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 201000004193 respiratory failure Diseases 0.000 description 1
- 210000005245 right atrium Anatomy 0.000 description 1
- 208000014221 sudden cardiac arrest Diseases 0.000 description 1
- 230000004083 survival effect Effects 0.000 description 1
- 208000011580 syndromic disease Diseases 0.000 description 1
- 230000008718 systemic inflammatory response Effects 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 238000002627 tracheal intubation Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3666—Cardiac or cardiopulmonary bypass, e.g. heart-lung machines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
Landscapes
- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Anesthesiology (AREA)
- Engineering & Computer Science (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- External Artificial Organs (AREA)
Abstract
本发明公开了一种用于预防下肢缺血的体外膜肺氧合装置，涉及医疗器械技术领域；它包括ECMO体外循环套包、连续性血液净化单元和远端灌注套管；ECMO体外循环套包通过ECMO管路动脉端与外周静脉导管连接，并通过ECMO管路静脉端的第一接口与外周动脉导管连接；连续性血液净化单元两端分别与ECMO管路静脉端的第二接口和远端灌注套管连接。本发明提供了一种用于预防下肢缺血的体外膜肺氧合装置，它可以解决现有技术的弊端，能够保证下肢血量供给，预防pV‑A ECMO下肢缺血情况出现，并同时保证ECMO及CRRT正常运行。
Description
技术领域
本发明涉及医疗器械技术领域，尤其是一种用于预防下肢缺血的体外膜肺氧合装置。
背景技术
体外膜肺氧合（ECMO）临床上提供心肺功能替代，是严重心脏功能不全和（或）呼吸功能不全患者的关键支持技术，按照血液回输的途径不同，通常ECMO有两种类型：从静脉系统引出动脉回输为静脉-动脉体外膜肺氧合（VA-ECMO），从静脉引出又注入静脉为静脉-静脉体外膜肺氧合（VV-ECMO）；其中VA-ECMO同时提供循环和呼吸支持，用于治疗顽固性心脏或心肺功能衰竭，也用于心脏骤停患者的抢救性辅助治疗，其适应症不断扩大。VA-ECMO置管方式主要有两种：一是中心血管置管（cV-A ECMO），管路直接插入右心房和升主动脉；二是外周血管置管（pV-A ECMO），选择在股动脉或腋窝血管插管，由于VA-ECMO多数用于非心脏切开术的心源性休克，股动脉血管的外周插管不需要胸部开口、可以快速建立、操作难度小、对比中心血管置管具有更低的出血风险，是大多数ECMO中心首选的穿刺置管方法。
但是外周血管置管的缺点是更高的下肢缺血并发症，肢体缺血的主要机制是血流量和相关的氧供应减少，这是由于远端组织的动脉血流绝对或相对不足，持续下肢缺血可导致腿部不可逆的损伤，它的影响可能是灾难性的，最严重的病例并发室间隔综合征，最终需要筋膜切开术甚至肢体截肢，此外，坏死的肌肉组织可产生横纹肌溶解，引起全身炎症反应失调和多器官功能障碍综合征，增加患者死亡率，对患者生存率和生活质量均产生严重负面影响。
为预防肢体缺血并发症，目前主流方法是在ECMO管路静脉端连接一条肢体远端灌注套管至外周动脉，但因分流到远端灌注套管的血流量无法控制，导致肢体缺血情况仍时有发生，同时VA-ECMO患者发生急性肾损伤（AKI）比例很高，常联合使用CRRT治疗，而常规CRRT连接在ECMO管路上只是单纯为了减少穿刺置管数量，减少ECMO期间出血风险，对预防肢体缺血无任何影响。因此开发一种能够保证下肢血量供给，预防pV-A ECMO下肢缺血情况出现，并同时保证ECMO及CRRT正常运行的装置是临床工作的迫切需求。
发明内容
本发明的目的是提供一种用于预防下肢缺血的体外膜肺氧合装置，它可以解决现有技术的弊端，能够保证下肢血量供给，预防pV-A ECMO下肢缺血情况出现，并同时保证ECMO及CRRT正常运行。
为了解决上述问题，本发明采用的技术方案是：这种用于预防下肢缺血的体外膜肺氧合装置，包括ECMO体外循环套包、连续性血液净化单元和远端灌注套管；所述ECMO体外循环套包通过ECMO管路动脉端与外周静脉导管连接，并通过ECMO管路静脉端的第一接口与外周动脉导管连接；所述连续性血液净化单元包括血液净化治疗机、CRRT动脉血液管路和CRRT静脉血液管路，所述CRRT动脉血液管路一端与所述血液净化治疗机连接，另一端与所述ECMO管路静脉端的第二接口连接，所述CRRT静脉血液管路一端与所述血液净化治疗机连接，另一端与所述远端灌注套管连接。
上述技术方案中，更具体的技术方案还可以是：所述ECMO体外循环套包还包括离心泵头和膜肺，所述离心泵头与所述ECMO管路动脉端连接，所述膜肺与所述ECMO管路静脉端连接。
由于采用了上述技术方案，本发明与现有技术相比具有如下有益效果：
本发明在外周血管置管静脉-动脉体外膜肺氧合期间，将CRRT和ECMO有效结合在一起，通过连续性血液净化单元连接ECMO体外循环套包的膜肺和远端灌注套管，将氧合后的动脉血进行净化，再从远端灌注套管输送至右侧股浅动脉血管，血液输送过程中能通过血液净化治疗机调节血流量，以满足肢体血量供给需求，最大程度地减少pV-A ECMO肢体缺血的情况发生，并且也无需增加穿刺置管数量，减少ECMO期间出血风险，保证CRRT和ECMO同时有效运行。
附图说明
图1是本发明的结构示意图。
具体实施方式
下面结合附图实施例对本发明作进一步详述：
如图1所示的用于预防下肢缺血的体外膜肺氧合装置，包括ECMO体外循环套包、连续性血液净化单元和远端灌注套管8；ECMO体外循环套包通过ECMO管路动脉端2与外周静脉导管1连接，并通过ECMO管路静脉端3的第一接口与外周动脉导管4连接；连续性血液净化单元包括血液净化治疗机6、CRRT动脉血液管路5和CRRT静脉血液管路7，CRRT动脉血液管路5一端与血液净化治疗机6连接，另一端与ECMO管路静脉端3的第二接口连接，CRRT静脉血液管路7一端与血液净化治疗机6连接，另一端与远端灌注套管8连接。
ECMO体外循环套包还包括离心泵头9和膜肺10，离心泵头9与ECMO管路动脉端2连接，膜肺10与ECMO管路静脉端3连接。
本发明在使用时，将外周静脉导管1插入右侧股静脉血管11，外周动脉导管4插入右侧股动脉血管12，远端灌注套管8插入右侧股浅动脉血管13，然后启动ECMO体外循环套包的离心泵头9，静脉血被引出，经外周静脉导管1和ECMO管路动脉端2进入ECMO体外循环套，血液在膜肺10氧合后，一部分血液从ECMO管路静脉端3经外周动脉导管4回输至右侧股动脉血管12，另一部分血液从ECMO管路静脉端3进入连续性血液净化单元，经过血液净化治疗机6净化血液后从远端灌注套管8回输至右侧股浅动脉血管13，血液流向如图1中箭头所示。
本发明在外周血管置管静脉-动脉体外膜肺氧合期间，将CRRT和ECMO有效结合在一起，通过连续性血液净化单元连接ECMO体外循环套包的膜肺10和远端灌注套管8，将氧合后的动脉血进行净化，再从远端灌注套管8输送至右侧股浅动脉血管13，血液输送过程中能通过血液净化治疗机6调节血流量，以满足肢体血量供给需求，最大程度地减少pV-A ECMO肢体缺血的情况发生，并且也无需增加穿刺置管数量，减少ECMO期间出血风险，保证CRRT和ECMO同时有效运行。
Claims (2)
1.一种用于预防下肢缺血的体外膜肺氧合装置，其特征在于：包括ECMO体外循环套包、连续性血液净化单元和远端灌注套管；所述ECMO体外循环套包通过ECMO管路动脉端与外周静脉导管连接，并通过ECMO管路静脉端的第一接口与外周动脉导管连接；所述连续性血液净化单元包括血液净化治疗机、CRRT动脉血液管路和CRRT静脉血液管路，所述CRRT动脉血液管路一端与所述血液净化治疗机连接，另一端与所述ECMO管路静脉端的第二接口连接，所述CRRT静脉血液管路一端与所述血液净化治疗机连接，另一端与所述远端灌注套管连接。
2.根据权利要求1所述的用于预防下肢缺血的体外膜肺氧合装置，其特征在于：所述ECMO体外循环套包还包括离心泵头和膜肺，所述离心泵头与所述ECMO管路动脉端连接，所述膜肺与所述ECMO管路静脉端连接。
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110755491.0A CN113456917A (zh) | 2021-07-05 | 2021-07-05 | 用于预防下肢缺血的体外膜肺氧合装置 |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110755491.0A CN113456917A (zh) | 2021-07-05 | 2021-07-05 | 用于预防下肢缺血的体外膜肺氧合装置 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113456917A true CN113456917A (zh) | 2021-10-01 |
Family
ID=77878087
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110755491.0A Pending CN113456917A (zh) | 2021-07-05 | 2021-07-05 | 用于预防下肢缺血的体外膜肺氧合装置 |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113456917A (zh) |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1995015192A1 (en) * | 1993-12-03 | 1995-06-08 | Heartport, Inc. | Cardiopulmonary bypass system for closed-chest intervention |
| US6083215A (en) * | 1995-07-17 | 2000-07-04 | Milavetz; James J. | Method and apparatus for antegrade coronary perfusion |
| CN202270211U (zh) * | 2011-09-28 | 2012-06-13 | 虞文魁 | 一种体外膜氧合氧合器与血液滤过机一体化装置 |
| CN110538353A (zh) * | 2019-08-19 | 2019-12-06 | 江苏赛腾医疗科技有限公司 | 体外心肺支持辅助系统 |
| US20200054817A1 (en) * | 2016-11-15 | 2020-02-20 | Assistance Publique Hopitaux De Paris | Cannula, ecmo assistance system |
| CN112155009A (zh) * | 2020-11-27 | 2021-01-01 | 首都医科大学附属北京世纪坛医院 | 人体器官血液氧合系统 |
| FR3103109A1 (fr) * | 2019-11-18 | 2021-05-21 | Novaflow | Canule artérielle bidirectionnelle pour oxygénation par membrane extracorporelle et procédé d’utilisation d’une telle canule |
| CN213347359U (zh) * | 2020-09-16 | 2021-06-04 | 清远市人民医院 | 一种新型ecmo远端灌注延长管 |
-
2021
- 2021-07-05 CN CN202110755491.0A patent/CN113456917A/zh active Pending
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1995015192A1 (en) * | 1993-12-03 | 1995-06-08 | Heartport, Inc. | Cardiopulmonary bypass system for closed-chest intervention |
| US6083215A (en) * | 1995-07-17 | 2000-07-04 | Milavetz; James J. | Method and apparatus for antegrade coronary perfusion |
| CN202270211U (zh) * | 2011-09-28 | 2012-06-13 | 虞文魁 | 一种体外膜氧合氧合器与血液滤过机一体化装置 |
| US20200054817A1 (en) * | 2016-11-15 | 2020-02-20 | Assistance Publique Hopitaux De Paris | Cannula, ecmo assistance system |
| CN110538353A (zh) * | 2019-08-19 | 2019-12-06 | 江苏赛腾医疗科技有限公司 | 体外心肺支持辅助系统 |
| FR3103109A1 (fr) * | 2019-11-18 | 2021-05-21 | Novaflow | Canule artérielle bidirectionnelle pour oxygénation par membrane extracorporelle et procédé d’utilisation d’une telle canule |
| CN213347359U (zh) * | 2020-09-16 | 2021-06-04 | 清远市人民医院 | 一种新型ecmo远端灌注延长管 |
| CN112155009A (zh) * | 2020-11-27 | 2021-01-01 | 首都医科大学附属北京世纪坛医院 | 人体器官血液氧合系统 |
Non-Patent Citations (1)
| Title |
|---|
| CARLO BANFI, MATTEO POZZI: "Veno-arterial extracorporeal membrane oxygenation: an overview of different cannulation techniques", 《JOURNAL OF THORACIC DISEASE》 * |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| Phillips et al. | Percutaneous cardiopulmonary bypass: application and indication for use | |
| Choi et al. | Clinical pearls of venoarterial extracorporeal membrane oxygenation for cardiogenic shock | |
| CN210020563U (zh) | 一种经皮左心辅助循环系统 | |
| Shawl et al. | Percutaneous cardiopulmonary bypass support in the catheterization laboratory: technique and complications | |
| Zwart et al. | First clinical application of transarterial closed-chest left ventricular (TaCLV) bypass | |
| Ng et al. | Clinical use of venoarterial extracorporeal membrane oxygenation | |
| Dalton et al. | Extracorporeal life support | |
| CN113456917A (zh) | 用于预防下肢缺血的体外膜肺氧合装置 | |
| Alexi-Meskishvili et al. | Successful extracorporeal circulatory support after aortic reimplantation of anomalous left coronary artery | |
| Kurose et al. | Extracorporeal life support for patients undergoing prolonged external cardiac massage | |
| CN116271418A (zh) | 一种ecmo-iabp复合双腔动脉插管 | |
| Inoue et al. | Percutaneous cardiopulmonary support for the treatment of right ventricular thrombus | |
| Bregman et al. | Mechanical Techniques of Circulation Support: A Percutaneous Intra‐aortic Balloon Device | |
| Shawl | Percutaneous cardiopulmonary support in high-risk angioplasty. | |
| Shawl et al. | Role of percutaneous cardiopulmonary bypass and other support devices in interventional cardiology | |
| Tanaka et al. | Transapical aortic perfusion with a double-barreled cannula | |
| Madan et al. | Cardiac Assist Devices | |
| Horan | Extracorporeal membrane oxygenation and mechanical support for the circulation | |
| Vakamudi | Weaning from cardiopulmonary bypass: problems and remedies. | |
| Resnekov | Circulatory assistance for the failing heart. | |
| Jotoku et al. | Venovenous extracorporeal membrane oxygenation as an adjunct to surgery for empyema: report of a case | |
| Prasad et al. | ECMO CONFIGURATIONS AND CANNULATION IN ADULT PATIENTS | |
| Wang | Physiology of Extracorporeal Life Support | |
| Nicolas et al. | Circulatory assistance by way of long-term cardiopulmonary bypass | |
| Haubert et al. | Clinical experience with a new pulsatile cardiac assist device |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
| RJ01 | Rejection of invention patent application after publication |
Application publication date: 20211001 |