国内体外膜肺氧合技术研究进展

doi:10.13475/j.fzxb.20230806202

Abstract

Abstract:

Significance Extracorporeal Membrane Oxygenation (ECMO) is an extracorporeal life support method. Since the outbreak of COVID-19, ECMO has achieved remarkable clinical results despite the high cost of consumables. On the other hand, the shortage of ECMO equipment and technical reserves in China becomes increasingly prominent, making it urgent to breakthrough the core technology for domestic ECMO production.In March 2021, the national "Fourteenth Five-Year Plan and 2035 Vision and Goals Outline" was released, calling for breakthroughs in extracorporeal membrane oxygenation machine and other core technologies, and the innovation research and development of domestic ECMO technology has been upgraded to the height of the national strategy since then. As part of the national effort, this paper reviews the research progress of ECMO in China and and tries to point out the future research directions.

Progress The working principle of ECMO extracorporeal membrane pulmonary oxygenation device was introduced in this review, and the centrifugal pump, control system, and oxygenator have been highlighted as the three key technologies for ECMO development. The progress of domestic research on the current technical difficulties was reviewed. Since the national policy was put forward, various medical research organizations have joined forces and overcome many key technologies of ECMO. The centrifugal pump in ECMO has been successively developed in China. The preparation technology of PMP (polymethylpentene)has been broken through, and the control system of ECMO equipment has been developed with the help of domestic leading aerospace technology. Since 2023, three ECMO products have been released domestically. The centrifugal pump product has a pump body speed of 7 000 r/min, which is better than that of 3M's 5 000 r/min; the maximum flow rate can reach 8 L/min, which is on a par with the performance of 3M's products. The porosity of domestic PMP membrane material can reach 60%, and the strength is more than 60 cN, which is the same as that of 3M products. Aiming at the development of manufacturing technology of PMP membrane, the organizational structure of 3M samples were studied and analyzed, and it was learnt that the structure of PMP membrane is warp knitting with pillar stitches. Through the trial experiment on the machine, it was found that the technical difficulties of the PMP membrane manufacturing process were mainly the selection of equipment and the control of weaving tension.

Conclusion and Prospect Through the study of ECMO key technologies, it was found that the focus of breakthrough oxygenator technology should be driven by the policy of frequent outbreaks and localization of ECMO technology, and PMP membrane preparation based on warp knitting technology is one of the important challenges in China for the future. It was found that the focus of breakthrough oxygenator technology should be the cross-fertilization of multidisciplinary collaborations. It is necessary to continuously optimize the physical properties of PMP membrane according to the requirements of knitting equipment, and it is necessary to develop special knitting equipment according to the mechanical properties of the PMP membrane to realize the complete localization of ECMO technology. In the future, the focus of ECMO technology development should be shifted from localized technology to international leading technology. Scientific researchers from various fields, such as textile technology, membrane technology, clinical medicine, and electromechanical engineering should work together to overcome the technological difficulties in different fields. The working efficiency of the ECMO equipment should be further optimized and improved in order to make advancement in the oxygenated membrane technology, and to promote the development of China's high-end medical equipment.

Key words: extracorporeal membrane oxygenation technology, oxygenation equipment, polymethylpentene hollow fiber membrane, braiding technology

CLC Number:

TS186.1

XI Lifeng, MA Pibo, JIA Wei, WANG Jiamian, ZHANG Hongbin, PENG Xiaoquan, XIA Fenglin, JIANG Gaoming. Research progress of extracorporeal membrane oxygenation technology in China[J].Journal of Textile Research, 2024, 45(08): 234-240.

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: http://www.fzxb.org.cn/EN/10.13475/j.fzxb.20230806202

http://www.fzxb.org.cn/EN/Y2024/V45/I08/234

Figures/Tables 7

Fig.1

Tab.1

Fig.2

Fig.3

Tab.2

Fig.4

Fig.5

References 31

[1]	任明仕, 董士勇, 申华, 等. 国产体外膜氧合设备的研发现状和应用前景[J]. 中国体外循环杂志, 2022, 20(6): 365-370.
	REN Mingshi, DONG Shiyong, SHEN Hua, et al. The research and development status and application prospect of domestic extracorporeal membrane oxygenation equipment[J]. Chinese Journal of Cardiopulmonary Bypass, 2022, 20 (6): 365-370.
[2]	王伟. ECMO 危重病体外心肺支持[M]. 3版. 北京: 中国环境科学出版社, 2011: 9-36.
	WANG Wei. Extracorporeal cardiopulmonary support in critically ill patients with ECMO[M]. 3rd ed. Beijing: China Environmental Science Press, 2011: 9-36.
[3]	杜宇倩, 邵丽萍, 潘福生, 等. 聚-4-甲基-1-戊烯中空纤维氧合膜的研究进展与面临的挑战[J]. 膜科学与技术, 2021, 41(3): 169-178.
	DU Yuqian, SHAO Liping, PAN Fusheng, et al. Research progress and challenges of poly-4-methyl-1-pentene hollow fiber membrane[J]. Membrane Science and Technology, 2021, 41(3): 169-178.
[4]	孟浩. 便携式体外生命支持系统的研制及其应用于深低温低流量下肺爆震伤救治的可行性研究[D]. 西安: 中国人民解放军空军军医大学, 2019: 1-49.
	MENG Hao. Development of a portable extracorporeal life support system and its feasibility study in the treatment of lung blast injury under deep hypothermia and low flow[D]. Xi'an: Air Force Medical University of Chinese People's Liberation Army, 2019: 1-49.
[5]	唐尚鸿, 洪小杨, 封志纯, 等. 早产儿体外膜氧合的应用现状与展望[J]. 中华儿科杂志, 2023, 61(1): 82-85.
	TANG Shanghong, HONG Xiaoyang, FENG Zhichun, et al. Application status and prospect of extracorporeal membrane oxygenation in premature infants[J]. Chinese Journal of Pediatrics, 2023, 61 (1): 82-85.
[6]	蔡子文, 张泰隆, 王寅, 等. ECMO在儿童心脏移植中的应用[J]. 器官移植, 2023, 14(1): 49-55.
	CAI Ziwen, ZHANG Tailong, WANG Yin, et al. Application of ECMO in pediatric heart transplanta-tion[J]. Organ Transplantation, 2023, 14(1): 49-55.
[7]	BRODIE D, BACCHETTA M. Extracorporeal membrane oxygenation for ARDS in adults[J]. New England Journal of Medicine, 2011, 365(20): 1905-1914.
[8]	金俊英. 运用ECMO支持重症新型冠状病毒肺炎患者的成功转运[J]. 中国急救复苏与灾害医学杂志, 2022, 17(1): 6-7.
	JIN Junying. Using ECMO to support the successful transport of patients with severe COVID-19[J]. Chinese Journal of Emergency Resuscitation and Disaster Medicine, 2022, 17 (1): 6-7.
[9]	KOLLENGODE R M D, DAVID A M, ALAIN C M, et al. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases[J]. The Lancet Respiratory Medicine, 2020, 8: 518-526.
[10]	俞晓梅, 倪伟伟, 夏明, 等. 体外膜肺氧合团队中护理人员的职能及发展现状[J]. 护理学杂志, 2020, 35(16): 107-110.
	YU Xiaomei, NI Weiwei, XIA Ming, et al. The functions and development status of nursing staff in extracorporeal membrane oxygenation team[J]. Journal of Nursing, 2020, 35 (16): 107-110.
[11]	铁娟, 张彩丽, 翁云宣. 体外膜氧合系统中膜材料的研究进展[J]. 膜科学与技术, 2020, 40(6): 141-147.
	TIE Juan, ZHANG Caili, WENG Yunxuan. Research progress of membrane materials in extracorporeal membrane oxygenation system[J]. Membrane Science and Technology, 2020, 40 (6): 141-147.
[12]	张智鑫, 李冬梅, 张瑞. 膜式氧合器的内部流场分析[J]. 机械设计, 2022, 39(7): 17-24.
	ZHANG Zhixin, LI Dongmei, ZHANG Rui. Internal flow field analysis of membrane oxygenator[J]. Mechanical Design, 2022, 39 (7): 17-24.
[13]	FAN E, DEL S L, GOLIGHER E C, et al. An official american thoracic society/european society of intensive care medicine/society of critical care medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome[J]. Am J Respir Crit Care Med, 2017, 195(9): 1253-1263.
[14]	MUNSHI L, WALKEY A, GOLIGHER E, et al. Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis[J]. The Lancet Respiratory Medicine, 2019, 7(17): 163-172.
[15]	首个国产“人工肺”获批上市[J]. 大众科学, 2023(1): 10.
	The first domestic "artificial lung" was approved for listing[J]. Public Science, 2023(1): 10.
[16]	简萌, 罗先武. ECMO氧合器血液流动数值模拟及损伤评估[J]. 工程热物理学报, 2023, 44(4): 977-986.
	JIAN Meng, LUO Xianwu. Numerical simulation and damage assessment of blood flow in ECMO oxygena-tor[J]. Journal of Engineering Thermophysics, 2023, 44(4): 977-986.
[17]	张凡臣, 唐元晖, 林亚凯, 等. 疏水性聚丙烯中空纤维膜制备方法及其应用研究进展[J]. 膜科学与技术, 2023, 43(3): 177-189.
	ZHANG Fanchen, TANG Yuanhui, LIN Yakai, et al. Advances in preparation and application of hydrophobic polypropylene hollow fiber membranes[J]. Membrane Science and Technology, 2023, 43(3): 177-189.
[18]	邱中勇, 何春菊. DIP法聚丙烯中空纤维纳滤膜[J]. 膜科学与技术, 2022, 42(3): 7-14.
	QIU Zhongyong, HE Chunju. DIP polypropylene hollow fiber nanofiltration membrane[J]. Membrane Science and Technology, 2022, 42 (3): 7-14.
[19]	叶非华, 易国斌. 可交联磷酰胆碱聚合物改性聚甲基戊烯中空纤维膜[J]. 复合材料学报, 2021, 38(2): 1-8.
	YE Feihua, YI Guobin. Crosslinkable phosphorylcholine polymer-modified polymethylpentene hollow fiber membrane[J]. Acta Materiae Compositae Sinica, 2021, 38 (2): 1-8.
[20]	HE Ting, YU Songhong. Membranes for extracorporeal membrane oxygenator(ECMO): history, preparation, modification and mass transfer[J]. Chinese Journal of Chemical Engineering, 2022, 49(9): 46-75. doi: 10.1016/j.cjche.2022.05.027
[21]	吴芳宇, 林亚凯, 汪林, 等. 聚4-甲基-1-戊烯膜的制备与应用研究进展[J]. 高分子通报, 2022(5): 1-9.
	WU Fangyu, LIN Yakai, WANG Lin, et al. Research progress on preparation and application of poly (4-methyl-1-pentene) membrane[J]. Polymer Bulletin, 2022 (5): 1-9.
[22]	郑珊珊, 郑哲, 宋云虎, 等. 体外膜肺氧合在心脏移植术后早期移植物功能障碍中的应用[J]. 器官移植, 2023, 14(1): 93-99.
	ZHENG Shanshan, ZHENG Zhe, SONG Yunhu, et al. Application of extracorporeal membrane oxygenation in early graft dysfunction after heart transplantation[J]. Organ Transplantation, 2023, 14 (1): 93-99.
[23]	费敏岚, 李亚民, 汪大亮, 等. 体外膜肺氧合支持下成功救治青少年严重胸部挤压伤1例[J]. 中华医学杂志, 2023, 103(1): 49-50.
	FEI Minlan, LI Yamin, WANG Daliang, et al. One case of severe chest crush injury in adolescents was successfully treated with extracorporeal membrane oxygenation[J]. Chinese Journal of Medicine, 2023, 103(1): 49-50.
[24]	李雅坤, 黑飞龙. 膜式人工肺中空纤维膜材料的改善及发展新方向[J]. 中国组织工程研究, 2022, 26(16): 2608-2612.
	LI Yakun, HEI Feilong. Improvement and development of hollow fiber membrane materials for membrane artificial lung[J]. China Tissue Engineering Research, 2022, 26 (16): 2608-2612.
[25]	许梦菲, 梁亚静, 臧慧, 等. 聚-4-甲基-1-戊烯中空纤维膜式人工肺组件的氧气传质性能的研究[J]. 南京大学学报(自然科学版), 2021, 57(4): 641-647.
	XU Mengfei, LIANG Yajing, ZANG Hui, et al. Study on oxygen mass transfer performance of poly-4-methyl-1-pentene hollow fiber membrane artificial lung module[J]. Journal of Nanjing University (Natural Science), 2021, 57(4): 641-647.
[26]	钟丁磊, 黄铎, 应翔, 等. 熔纺-选择性溶胀制备嵌段共聚物多通道中空纤维膜[J]. 化工进展, 2023(6): 1-12.
	ZHONG Dinglei, HUANG Duo, YING Xiang, et al. Melt spinning-selective swelling preparation of block copolymer multi-channel hollow fiber membrane[J]. Chemical Progress, 2023 (6): 1-12.
[27]	郑可欣, 曹淼, 徐禹, 等. 泡沫敷料联合3M液体敷料对ECMO患者股静脉置管处皮肤保护的效果研究[J]. 现代中西医结合杂志, 2020, 29(10): 1123-1125.
	ZHENG Kexin, CAO Miao, XU Yu, et al. The effect of foam dressing combined with 3M liquid dressing on the skin protection of femoral vein catheterization in patients with ECMO[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2020, 29 (10): 1123-1125.
[28]	LI J, HE T, CHEN H, et al. Preparation of hyflon AD/polypropylene blend membrane for artificial lung[J]. Membranes, 2023, 13(7): 1-6.
[29]	严佳, 李刚. 医用纺织品的研究进展[J]. 纺织学报, 2020, 41(9): 191-200.
	YAN Jia, LI Gang. Research progress of medical textiles[J]. Journal of Textile Research, 2020, 41(9): 191-200.
[30]	吴洋, 刘方恬, 曹孟杰, 等. 生物质纤维医用敷料研究进展[J]. 纺织学报, 2022, 43(3): 8-16.
	WU Yang, LIU Fangtian, CAO Mengjie, et al. Research progress of biomass fiber medical dressings[J]. Journal of Textile Research, 2022, 43(3): 8-16.
[31]	乔燕莎, 毛迎, 徐丹瑶, 等. 用于应对疝修补术后并发症的经编补片研究进展[J]. 纺织学报, 2022, 43(3): 1-7.
	QIAO Yansha, MAO Ying, XU Danyao, et al. Research progress of warp-knitted mesh used to deal with complications after hernia repair[J]. Journal of Textile Research, 2022, 43 (3): 1-7.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 0

No Suggested Reading articles found!

类型	预充量/ mL	转速/ (r·min^-1)	最大流量/ (L·min^-1)	轴承座	离心泵类型
迈柯唯	32	0~5 000	10	单轴承	径向泵
理诺法	57	0~3 500	8	单轴承	径向泵
索林	17	0~10 000	8	单轴承	对角泵
国产产品	16	0~7 000	8	单轴承	对角泵

产品开发单位	外径/ μm	内径/ μm	致密层厚度/μm	孔隙率/ %	完全泡点/MPa	拉伸强力/cN
3M公司	380±30	200±50	0.4	61	>0.4	>60
清华大学	580±30	350±50	—	60~70	>0.4	110~115
南京工业大学	400±30	200±30	—	≥ 55	—	≥ 70
深圳国家高性能医疗器械创新中心	400±30	200±30	—	60	—	≥60

Research progress of extracorporeal membrane oxygenation technology in China

RichHTML

PDF (PC)

Abstract

Cite this article

share this article

Figures/Tables 7

References 31

Related Articles 2

Metrics

Comments

Recommended 0

[1]	XI Lifeng, JIANG Gaoming, MA Pibo, JIA Wei, ZHANG Hongbin, WANG Jiamian, XIA Fenglin, ZHANG Qi, LIU Haisang. Low-damage preparation of extracorporeal membrane oxygenation warp knit membrane fabrics with adaptive tension [J]. Journal of Textile Research, 2024, 45(07): 1-9.
[2]	. Braiding technologies of 2-D braided carbon fiber tubular fabrics [J]. JOURNAL OF TEXTILE RESEARCH, 2018, 39(06): 64-69.