Abstract:
We developed a new artificial placenta (AP) system consisting of a loop circuit configuration extracorporeal membrane oxygenation (ECMO) with a bridge circuit designed to be applied to the fetus in the form of an umbilical arterial-venous connection. We aimed to evaluate the feasibility of the AP system by performing a hydrodynamic simulation using a mechanical mock circulation system and fetal animal experiment. The effect of the working condition of the AP system on the fetal hemodynamics was evaluated by hydrodynamic simulation using a mechanical mock circulation system, assuming the weight of the fetus to be 2 kg. The AP system was introduced to two fetal goats at a gestational age of 135 days. The general conditions of the experimental animals were evaluated. The mock simulation showed that in an AP system with ECMO in the form of an umbilical arterial-venous connection in series, it could be difficult to maintain fetal hemodynamics when high ECMO flow was applied. The developed AP system could have high ECMO flow with less umbilical blood flow; however, the possibility of excessive load on the fetal right-sided heart should be noted. In the animal experiment, kid 1 (1.9 kg) was maintained on the AP system for 12 days and allowed to grow to term. In kid 2 (1.6 kg), the AP system could not be established because of the occlusion of the system by a thrombus. The developed AP system was feasible under both in vitro and in vivo conditions. Improvements in the AP system and management of the general fetal conditions are essential.
摘要:
我们开发了一种新的人工胎盘(AP)系统,该系统由环路电路配置的体外膜氧合(ECMO)组成,其桥接电路旨在以脐动静脉连接的形式应用于胎儿。我们旨在通过使用机械模拟循环系统和胎儿动物实验进行流体动力学模拟来评估AP系统的可行性。通过使用机械模拟循环系统的流体动力学模拟来评估AP系统的工作条件对胎儿血流动力学的影响,假设胎儿的体重为2公斤。将AP系统引入胎龄为135天的两只胎儿山羊。评价实验动物的一般状况。模拟模拟表明,在具有ECMO的脐动脉-静脉串联连接形式的AP系统中,当应用高ECMO流量时,可能难以维持胎儿血流动力学.开发的AP系统可以具有高ECMO流量,脐血流量较少;但是,应注意胎儿右侧心脏过度负荷的可能性。在动物实验中,儿童1(1.9公斤)在AP系统上维持12天,并允许其生长至足月。在孩子2(1.6公斤)中,由于系统被血栓阻塞,因此无法建立AP系统。开发的AP系统在体外和体内条件下都是可行的。AP系统的改进和一般胎儿状况的管理至关重要。