New neonatal extracorporeal membrane oxygenation circuit with a self-regulating blood pump.
BACKGROUND
Because a roller pump used in a conventional extracorporeal membrane oxygenation (ECMO) circuit with a roller pump cannot change the output automatically according to the venous return, ECMO management requires considerable personnel to prevent serious mechanical complications. An automatic blood pump will make ECMO less laborious and safer.


METHODS
Takagi's self-regulating blood pump was modified for neonatal ECMO. The new ECMO circuit was tested in a simulation circuit, in puppies, and in two neonates clinically. Self-regulation of the pump was studied in response to various hemodynamic conditions.


RESULTS
The priming volume including a membrane lung and a heat exchanger was about 90 ml. The maximum flow was 700 ml/min in the simulation circuit, 101 ml/min/kg in puppies, and 113 and 135 ml/min/kg in two newborns, respectively. ECMO flow was self-regulating and stable in response to hemodynamic changes. The blood pumps remained functional for more than 400 hours in puppies and 67 and 149 hours in the two newborns, respectively.


CONCLUSIONS
The new automatic ECMO circuit is more reliable and requires less personnel than a conventional ECMO circuit.
Seo
T
T
Department of Surgery, Branch Hospital, Nagoya University School of Medicine, Japan.
Ito
T
T
Ishiguro
Y
Y
Takagi
H
H
D000818:Animals; D000831:Animals, Newborn; D004285:Dogs; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D006548:Hernia, Diaphragmatic / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007260:Infusion Pumps; D008297:Male