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静脉内氧合器(Intravascular membrane oxygenator,IVOX)是一种置入人体腔静脉的人工肺,能为呼吸衰竭患者提供肺外气体交换。但腔静脉有限的容积限制了IVOX的交换面积和氧合效率,如增加IVOX的直径以增加气体交换面积,则可能导致静脉回流阻塞而影响血流动力学稳定。因此改进氧合器的结构以降低血液边流的扩散阻力,成为提高其氧合效果的重要手段。本研究将IVOX的中空纤维编织成辫子式,体外测试这种辫式IVOX氧合效果及其对血流阻力的影响。结果表明,当血流量为5.0L/min时(血红蛋白为120g/L),氧交换量[(55.97±0.51)ml/min]和氧传递速率[(127.19±0.66)ml/(min·m2)]显著高于血流量为4.0L/min(P<0.05)及3.5L/min(P<0.01)。当血流量由3.5L/min升高到4.0、5.0L/min,测试回路内的压力差也从(11.87±1.57)cmH2O增加至(18.53±0.99)、(19.77±0.51)cmH2O,但仍在安全范围内(<20cmH2O)。研究结果说明,这种辫式氧合器能为成年患者提供20%～30%的氧需要量,且不影响患者安全。
Intravascular membrane oxygenator (IVOX) is an artificial lung placed in the human vena cava and provides extrapulmonary gas exchange for patients with respiratory failure. However, the limited volume of the vena cava limits the exchange area and oxygenation efficiency of IVOX. Increasing the diameter of IVOX to increase the gas exchange area may result in obstruction of venous return and affect the hemodynamic stability. Therefore, improving the structure of the oxygenator to reduce the diffusion resistance of the blood sidestream has become an important means to improve its oxygenation effect. In this study, IVOX hollow fibers were braided and tested in vitro for this braid-type IVOX oxygenation effect and its effect on blood flow resistance. The results showed that the oxygen exchange capacity [(55.97 ± 0.51) ml / min] and oxygen delivery rate [(127.19 ± 0.66) ml / (min · m2) ] Was significantly higher than blood flow of 4.0 L / min (P <0.05) and 3.5 L / min (P <0.01). The pressure difference in the test circuit increased from (11.87 ± 1.57) cmH2O to (18.53 ± 0.99), (19.77 ± 0.51) cmH2O when blood flow increased from 3.5 L / min to 4.0 and 5.0 L / min, Safe range (<20cmH2O). The findings suggest that this braided oxygenator provides adult patients 20% to 30% oxygen requirements without compromising patient safety.