Asunto(s)
Circulación Extracorporea , Puente Cardiopulmonar/historia , Puente Cardiopulmonar/tendencias , Difusión de Innovaciones , Circulación Extracorporea/historia , Circulación Extracorporea/tendencias , Oxigenación por Membrana Extracorpórea/historia , Oxigenación por Membrana Extracorpórea/tendencias , Historia del Siglo XX , Historia del Siglo XXI , HumanosAsunto(s)
Procedimientos Quirúrgicos Cardíacos/historia , Circulación Extracorporea/historia , Cardiopatías Congénitas/historia , Procedimientos Quirúrgicos Cardíacos/métodos , Preescolar , Circulación Extracorporea/métodos , Femenino , Cardiopatías Congénitas/cirugía , Historia del Siglo XX , Humanos , Lactante , Masculino , MinnesotaRESUMEN
Alexis Carrel and Charles Lindbergh were among the most famous international figures in the 20th century: Carrel, the surgeon-scientist who won a Nobel prize as a young surgeon, and Lindbergh, the aviator-engineer who pioneered aviation and promoted commercial flight throughout his life. Surprisingly, these two amazing individuals came together to collaborate on the early development of extracorporeal circulation. Their work was interrupted by the onset of World War II, which destroyed one of them and nearly destroyed the other.
Asunto(s)
Aviación/historia , Procedimientos Quirúrgicos Cardiovasculares/historia , Conducta Cooperativa , Circulación Extracorporea/historia , Personajes , Francia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Nacionalsocialismo/historia , Premio Nobel , Cirujanos/historia , Estados UnidosAsunto(s)
Investigación Biomédica , Circulación Extracorporea , Máquina Corazón-Pulmón , Investigación Biomédica/economía , Investigación Biomédica/historia , Investigación Biomédica/métodos , Circulación Extracorporea/economía , Circulación Extracorporea/historia , Circulación Extracorporea/métodos , Máquina Corazón-Pulmón/economía , Máquina Corazón-Pulmón/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Factores de TiempoRESUMEN
The world's first implantable total artificial heart was designed by Vladimir Demikhov as a fourth year biology student in Voronezh, Soviet Union, in 1937. As a prototype of his device, Demikhov must have used an apparatus for extracorporeal blood circulation invented by Sergei Bryukhonenko of Moscow. The device was the size of a dog's native heart and consisted of two diaphragm pumps brought into motion by an electric motor. A dog with an implanted device lived for 2.5 hours. In addition to having the prototype, the preconditions for Demikhov's artificial heart creation were his manual dexterity, expertise in animal physiology, and his mechanistic worldview.
Asunto(s)
Circulación Extracorporea/historia , Corazón Artificial/historia , Animales , Perros , Historia del Siglo XX , U.R.S.S.RESUMEN
Extracorporeal organ support in patients with dysfunction of vital organs like the kidney, heart, and liver has proven helpful in bridging the patients to recovery or more definitive therapy. Mechanical ventilation in patients with respiratory failure, although indispensable, has been associated with worsening injury to the lungs, termed ventilator-induced lung injury. Application of lung-protective ventilation strategies are limited by inevitable hypercapnia and hypercapnic acidosis. Various alternative extracorporeal strategies, proposed more than 30 years ago, to combat hypercapnia are now more readily available. In particular, the venovenous approach to effective carbon dioxide removal, which involves minimal invasiveness comparable to renal replacement therapy, appears to be very promising. The clinical applications of these extracorporeal carbon dioxide removal therapies may extend beyond just lung protection in ventilated patients. This article summarizes the rationale, technology and clinical application of various extracorporeal lung assist techniques available for clinical use, and some of the future perspectives in the field.
Asunto(s)
Dióxido de Carbono/sangre , Dióxido de Carbono/aislamiento & purificación , Circulación Extracorporea/métodos , Catéteres , Diseño de Equipo , Circulación Extracorporea/historia , Circulación Extracorporea/instrumentación , Oxigenación por Membrana Extracorpórea/historia , Oxigenación por Membrana Extracorpórea/instrumentación , Oxigenación por Membrana Extracorpórea/métodos , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Pulmón/patología , Insuficiencia Respiratoria/terapiaRESUMEN
Cardiopulmonary bypass (CPB) is a standard procedure in cardiac surgery; however, apart from its therapeutic options a CPB might also initiate systemic and organ-specific complications, such as heart failure, renal and pulmonary dysfunction, impaired coagulation as well as neurological and cognitive dysfunction. The immunological response to the extracorporeal circulation generates systemic inflammation which often meets the definition of systemic inflammatory response syndrome (SIRS). The main inducers of SIRS are contact of blood with the artificial surfaces of the CPB, mechanical stress which affects the blood components and the extensive surgical trauma. Hence, a number of technical and surgical developments aim at reduction of the inflammatory response caused by the CPB. By reason of surgical demands, the majority of cardiothoracic procedures still depend on the use of CPB; however, there is an on-going development of new techniques trying to reduce the surgical trauma and the negative consequences of CPB. Here, minimized systems with biocompatible surfaces have been shown to be effective in attenuating the inflammatory response to CPB. Alternative procedures such as off-pump surgery may help to avoid CPB-associated complications but due to specific limitations will not replace conventional bypass surgery.