The first domestic extracorporeal membrane oxygenation was successfully developed, and the first domestic extracorporeal membrane oxygenation equipment was successfully developed. The extracorporeal membrane oxygenation equipment (extracorporeal membrane oxygenation) has always been imported. This domestic extracorporeal membrane oxygenation equipment broke through the foreign technical monopoly and successfully developed the first extracorporeal membrane oxygenation made in China.
The first extracorporeal membrane oxygenation in China was successfully developed1165438+10. On 8 October, the reporter learned from the First Affiliated Hospital of Xi Jiaotong University that the first extracorporeal membrane oxygenator in China was jointly developed by the First Affiliated Hospital of Xi Jiaotong University, the National Biomedical Materials Engineering Technology Research Center of Sichuan University and the School of Mechanical Engineering of Xi Jiaotong University.
The successful application of domestic extracorporeal membrane oxygenation in clinic has broken the monopoly of foreign products in this field, achieved the breakthrough of independent research and development of domestic major medical devices, and solved the "bottleneck" problem of treatment for critically ill cardiovascular patients. This "great country and heavy weapon" in the field of medical and health care is another major scientific research achievement in the establishment of the National Medical Center by the First Hospital of Xi Jiaotong University.
Extracorporeal membrane oxygenation (ECMO) is a powerful weapon against death in patients with severe cardiopulmonary failure, but its core key technology has long been monopolized by foreign countries, and its equipment and consumables are expensive, which is a "bottleneck" problem in the health field. It is urgent to develop domestic extracorporeal membrane oxygenation.
Cardiovascular team of the First Affiliated Hospital of Xi Jiaotong University is one of the earliest units in China to carry out clinical work of extracorporeal membrane oxygenation. Engaged in the clinical application and related research of extracorporeal membrane oxygenation for more than 20 years, it is also one of the earliest units in China to develop membrane oxygenator, perfusion pipeline and other medical devices.
The first extracorporeal membrane oxygenation system successfully developed by the team has been successfully applied in clinic, which is expected to greatly reduce the domestic price of extracorporeal membrane oxygenation products, promote the popularization of extracorporeal membrane oxygenation technology to primary hospitals, and benefit more critically ill patients, with great strategic significance and social benefits.
The first extracorporeal membrane oxygenation in China was successfully developed 2 Recently, the first extracorporeal membrane oxygenation equipment in China was successfully developed and applied in clinic. Yuan Zuyi, director of the Cardiovascular Department of the First Affiliated Hospital of Xi Jiaotong University, said that extracorporeal membrane oxygenation equipment (extracorporeal membrane oxygenation) has long relied on imports. This kind of domestic extracorporeal membrane oxygenation equipment broke through the monopoly of foreign technology, and also adopted new technologies such as magnetic navigation and magnetic control technology.
fundamental principle
In extracorporeal membrane oxygenation, blood is pumped from vein, oxygenated through membrane and carbon dioxide is discharged. Oxygenated blood can be reinjected into vein (V-V bypass) or artery (arteriovenous bypass).
V-V commutation:
It is mainly used for extracorporeal respiratory support, and the venous blood is partially exchanged before it flows through the lungs to make up for the deficiency of lung function. V-V transfer flows through one vein to draw venous blood, and then after oxygen is combined with carbon dioxide removed by oxygenator, it is pumped into another vein. Usually, the femoral vein is led out and the internal jugular vein is pumped in. Bilateral femoral veins can also be selected according to the patient's situation. V-V bypass is suitable for cases with simple lung function impairment and no risk of cardiac arrest. V-V bypass can only partially replace lung function, because only a part of blood is oxygenated in advance and there is repeated circulation in the pipeline. Repeated circulation phenomenon refers to that part of blood is pumped into vein through extracorporeal membrane oxygenation pipeline, and then inhaled into extracorporeal membrane oxygenation pipeline for repeated oxygenation.
Voltage-current conversion:
It can be used not only for extracorporeal respiratory support, but also for heart support. Blood pump can replace the pumping function of the heart and maintain blood circulation. Arteriovenous bypass draws venous blood from veins, and pumps venous blood into arteries after oxygen is combined with carbon dioxide removed by oxygenator. V-A bypass is a connection method to support cardiopulmonary function, which is suitable for heart failure, severe lung failure and possible cardiac arrest. The extracorporeal circulation pipeline of V-A bypass is connected in parallel with the heart and lung, which will increase the afterload of the heart and reduce the pulmonary blood flow. After long-term operation, pulmonary edema and even pink foam sputum may appear. In addition, when the heart stops completely, the blood in the heart stays in V-A mode, which is easy to produce thrombus and lead to irreversible damage.
The mode of extracorporeal membrane oxygenation should be flexibly selected according to the etiology and condition. Generally speaking, V-V bypass is a lung replacement method, while V-A bypass is a combined heart-lung replacement method.
Extracorporeal membrane oxygenation is mainly suitable for the following aspects:
Patients with cardiac arrest
Patients with acute severe heart failure
Patients with acute severe respiratory failure
Other diseases that seriously threaten respiratory and circulatory functions.
Organ transplant support, waiting for donors
The first extracorporeal membrane oxygenation device in China has been successfully developed. The extracorporeal membrane oxygenation device (hereinafter referred to as extracorporeal membrane oxygenation) has been monopolized by foreign countries and is a "neck-stuck" problem in the treatment of critically ill cardiovascular patients in China. At present, the first domestic extracorporeal membrane oxygenation system has been successfully applied in clinic, which has achieved a breakthrough in the independent research and development of major domestic medical devices and cracked the "big country" in the medical and health field. 165438+1On October 8th, the First Affiliated Hospital of Xi Jiaotong University held a press conference on "Domestic extracorporeal membrane oxygenation R&D achieves a major breakthrough in clinical use". Hong Yan, Vice President of xi Jiaotong University, Yao Xiong, Director of Shaanxi US Food and Drug Administration, Lu Yi, Dean of the First Affiliated Hospital of Xi Jiaotong University, Han Ju, Deputy Secretary, Yuan Zuyi, Dean of Cardiovascular Hospital, Yan Yang, Director of Cardiovascular Surgery, Professor of School of Mechanical Engineering of Xi Jiaotong University, Zhuang Jian, Xi 'an
Extracorporeal membrane oxygenation was jointly developed by the First Affiliated Hospital of Xi Jiaotong University, the National Biomedical Materials Engineering Technology Research Center of Sichuan University and the School of Mechanical Engineering of Xi Jiaotong University. Professor Yuan Zuyi and Professor Yan Yang from the Cardiovascular Hospital of the First Affiliated Hospital of Xi Jiaotong University took the lead in applying the first extracorporeal membrane oxygenation system in China to clinical practice, and successfully treated two critically ill cardiovascular patients.
The cardiovascular team of the First Affiliated Hospital of Xi Jiaotong University has been engaged in the clinical application and related research of extracorporeal membrane oxygenation for more than 20 years. Looking back at the research and development of extracorporeal membrane oxygenation in China, it is inseparable from the assistance of the government, teamwork and integration of learning and research. In 20 17, the team cooperated with Academician Zhang Xingdong, Director Wang Yunbing of National Biomedical Materials Engineering Technology Research Center of Sichuan University, Professor Zhuang Jian of School of Mechanical Engineering of Anjiao University and Xi 'an Gong Jing Medical Science and Technology Company to deeply design and develop the long-acting anticoagulant coating on the whole blood contact surface of extracorporeal membrane oxygenation equipment, magnetic levitation centrifugal pump, ultrasonic flow probe, program-controlled monitoring system and extracorporeal membrane oxygenation membrane lung. Before the outbreak of COVID-19 in 2020, the R&D team had basically completed the trial-manufacture of centrifugal pump equipment and a full range of consumables for extracorporeal membrane oxygenation, and conducted large-scale animal experiments on anticoagulant coatings.
The first extracorporeal membrane oxygenation system successfully developed by the team in China has been successfully applied in clinic, which is expected to greatly reduce the domestic price of extracorporeal membrane oxygenation products, promote the popularization of extracorporeal membrane oxygenation technology to primary hospitals and benefit more critically ill patients. Next, the First Affiliated Hospital of Xi Jiaotong University will continue to conduct a series of research on key cardiovascular equipment.