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人工膜肺氧合器技术进展

Recent Development of Extracorporeal Membrane Oxygenator

  • 摘要: 人工膜肺氧合器,又称人工膜肺组件或人工膜肺,是体外膜肺(ECMO)系统中2个最重要的核心部件之一,用于实现对静脉血液的供氧和二氧化碳的清除,支持病人建立体外心肺循环。人工膜肺氧合器是膜组件的一种,在ECMO系统中属于耗材,寿命一般较短且成本较高,目前第三代人工膜肺技术依然存在较多问题,需进一步开发基于新原理和新材料的人工膜肺组件。为此,基于人工膜肺发展历程,从膜材料的制备、膜材料的生物相容性、组件的设计、微流控人工膜肺等方面综述人工膜肺的发展现状,重点综述基于微流控原理的人工膜肺的研究进展。最后,对人工膜肺氧合器技术未来的发展方向进行展望,即在传统中空纤维式膜肺氧合器方面,需进一步开发新的高透气材料并优化组件内流路;在新型微流控膜肺方面,需在芯片并行放大、生物相容性改性及加工制备方法上进一步突破。

     

    Abstract: The extracorporeal membrane oxygenator, or termed artificial membrane contactor or artificial membrane lung, is one of the two most important core components in an ECMO system. Its function is to realize the oxygen supply and the removal of carbon dioxide of venous blood, and establish the extracorporeal gas circulation for patient. The artificial membrane oxygenator is one kind of membrane contactors, which is a membrane separation device, using special polymer membrane material as the separation unit. The service life of the artificial membrane oxygenator is generally short, and it is a consumable part in an ECMO system. Due to expensive membrane contactors, the cost of the ECMO system is greatly affected by the cost of this component. At present, there are still many problems in the third generation of artificial membrane lung technology, so it is necessary to further develop extracorporeal membrane oxygenator based on new principles and new materials. Therefore, based on the development history of artificial membrane lung, the development status of artificial membrane lung was reviewed from the preparation of membrane materials, biocompatibility of membrane materials, module design, i.e., the development of membrane, the improvement of biocompatibility of the membrane, the design of contactors, microfluidics artificial membrane lung and other aspects,with emphasis on the research progress of artificial membrane lung based on the principle of microfluidics. Finally, the future development direction of artificial membrane oxygenator technology was prospected, that is, in terms of the traditional hollow fiber membrane contactors, new materials of high gas permeation feature need to be developed and the flow path in the contactors need to be optimized. For microfluidics membrane contactors, the further breakthrough should be remained in scaling up of contactors, improvement of biocompatibility and new fabrication method.

     

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