Application of the hottest plastic in cardiopulmon

2022-10-14
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Application of plastics in cardiopulmonary bypass surgery

cardiopulmonary bypass has been used in open heart surgery in cardiovascular surgery for nearly half a century. In May, 1953, American gibbon realized the idea of applying cardiopulmonary bypass to open heart surgery for the first time in human history. In June, 1958, Professor suhongxi of the Fourth Military Medical University successfully repaired ventricular septal defect for a 6-year-old boy. This is the first open heart surgery under cardiopulmonary bypass in China. The statistics of cardiac surgery in China in 2004 were 88672 cases

current situation of cardiopulmonary bypass and cardiovascular disease: with the progress of society and the development of medicine, cardiovascular surgery is also developing rapidly. China has a large population, not only a large number of valve disease surgery, but also about 40000 cases of congenital heart disease need treatment every year. Coupled with the advent of an aging society and the improvement of people's living standards, the intake of high cholesterol foods has also led to an irrational increase in the dietary structure, followed by an increase in the incidence of coronary heart disease and macrovascular disease incidence rate year by year. In the next 10 years, the incidence rate of coronary heart disease among middle-aged men in China will increase a lot, so coronary heart disease bypass surgery will rise to the main surgical item for a considerable period of time in the future

the surgical treatment of all these diseases is inseparable from the support of cardiopulmonary bypass. In short, the need for open heart surgery promotes the emergence and development of cardiopulmonary bypass, which in turn provides a prerequisite and guarantee for the development of cardiovascular surgery

performance requirements of plastics used for cardiopulmonary bypass:

1 The chemical performance is stable, inactive, and will not rotate due to the chain connected with blood or tissue. According to the number of columns, the hydraulic universal testing machine can be divided into two series: B-type machine (two columns and two lead screws) and D-type machine (four columns and two lead screws), which will affect the changes of materials and cause blood and tissue damage

2. Good biocompatibility, no complex biological, physical, chemical and other damaging reactions occur in the interaction with human body. It has good compatibility with blood. It has good anticoagulant performance, that is, it does not produce thrombus on the plastic surface, does not cause the reduction of red blood cells after hemolysis, does not cause the deformation of protein in blood, does not destroy the effective components in blood, and does not cause infection centered on biomaterials

3. It has good histocompatibility, and the material will not cause inflammatory and foreign body reactions to surrounding tissues

4. No carcinogenicity. No allergy, no damage to adjacent tissues, no interference with the immune mechanism of the body, and no calcification on the surface of the material

5. Good biological aging resistance. Long term prevention of materials in the body will not lose tensile strength and elasticity. It has sufficient chemical stability and physiological inertia, and its physical and mechanical properties do not change significantly (excluding degradable materials)

6 It will not deteriorate, deform or denature in the process of high pressure, drying, sterilization (ethylene oxide), liquid medicine and other disposal

7. The content of heavy metals in the polymer is low, and the content of dissolved and soluble substances is low

8 Rich sources of materials, easy to form and process, low cost

application of plastics in cardiopulmonary bypass: a large part of the surgical treatment of cardiovascular diseases depends on cardiopulmonary bypass. The products made of plastics in cardiopulmonary bypass mainly include: artificial heart, artificial heart valve, heart patch, artificial blood vessel, cardiac catheter Oxygenator (bubbling oxygenator or membrane oxygenator is filled more fully in each box) and its matching intracardiac blood collector (blood storage filter), arterial micro thrombus filter, barrier pressure sensor, arterial intubation, venous intubation, left cardiac intubation (atrial tube), aortic perfusion needle (aortic direct perfusion tube), left cardiac aspirator, right cardiac aspirator and other disposable plastic consumables

bubbling oxygen concentrator

arterial micro thrombus filter

1 Artificial heart is to use mechanical methods to deliver blood to various organs of the body to replace the function of the heart. The plastic used in artificial heart is mainly polyether urethane, which has the characteristics of multiple bending resistance, good elasticity and compliance, anti-aging, good tissue compatibility and blood compatibility. Heart valve is a one-way valve in the heart to prevent blood backflow. It is a mechanical valve made of plastic used in clinic. It is mainly made of methyl vinyl silicone rubber combined with our resources and proprietary technology

2. Heart patch is mainly used to repair atrial septal defect and ventricular septal defect of congenital heart disease. At present, products made of expanded tetrafluoroethylene and polyester felt materials are widely used in clinic

3. Artificial blood vessels are required to be free of condensation, leakage, rupture and allergy. High quality artificial blood vessels should also avoid rejection reactions. Generally, the selected materials are polytetrafluoroethylene, polyvinyl chloride fiber, polyurethane and other materials

4. Cardiac catheterization is mainly used for cardiac interventional examination and treatment of congenital heart disease, rheumatic heart disease, pulmonary heart disease, etc. At present, the main materials used to make cardiac catheters have been changed from PVC and PTFE to polyurethane

5. Oxygenator is an important part of cardiopulmonary bypass circuit. Its function is to temporarily replace the function of human lungs in cardiac surgery and wake up the blood with a device for gas exchange, also known as artificial lung. According to different gas exchange materials, it can be divided into bubble oxygenator or membrane oxygenator. The latter is also an updated product of the former. The shell of the oxygenator is made of modified polystyrene (PVC) and polycarbonate. Sometimes several experimental pieces are made into a set of experiments to test the strength. It is made of ester (PC), acrylonitrile styrene copolymer (as) and other materials. The comprehensive performance of the shell made of polycarbonate is far better than that of the shell made of modified polystyrene. The gas exchange materials of membrane oxygenator are made of polypropylene hollow fiber or poly, hollow fiber and other materials. At present, such raw materials still rely on imports

6. Arterial micro thrombus filter: it is mainly used to place it on the arterial road to effectively filter all kinds of micro thrombus particles (solid embolus, gas embolus) and bubbles in oxygenated blood. The shell of arterial micro plug filter is usually made of polycarbonate and other materials

7. Various pipelines in the extracorporeal circulation pipeline: it is used to connect with various intubations, artificial cardiopulmonary machines, arterial micro thrombus filters and oxygenators. It is used for the drainage and blood supply of static and arterial blood. Including: aortic drainage tube, venous drainage tube, intracardiac suction tube, extracardiac suction tube, aortic pump tube, perfusion tube, perfusion pump tube, intracardiac suction pump tube, extracardiac suction pump tube, etc. It is usually made of medical PVC, polyethylene and other materials

8. Intubation: including aortic intubation, venous intubation and deep venous intubation. These cannulas are mainly used for drainage, examination and blood supply during surgery. The soft pipe body or rigid plastic reinforced by steel wire and the materials used for joints include: medical grade PVC, polyurethane, polyethylene, polytetrafluoroethylene, etc

9. Intracardiac blood collector (blood storage filter): its function is to recover the blood of intracardiac suction tube and extracardiac suction device during operation. Its shell is usually made of polycarbonate and other materials

10. The function of these connectors is mainly to connect various intubations, pipelines, artificial heart and lung machines, filters and oxygenators during surgery. It is usually made of medical grade PVC, polycarbonate and other materials

11. Perfusion device: it is used to stop the heart and protect the myocardium. Including filling needle and pipeline. The pipe is composed of pump pipe, joint, temperature change device, pipeline and joint, etc. The materials used include medical grade PVC, polyethylene and other materials

12. Barrier pressure sensor: it is used to protect the instrument for monitoring pressure. It is mainly composed of shell, diaphragm, connecting pipe, Ruhr street, tee cock, etc. The material is made of medical grade PVC and polycarbonate

13. Pressure extension pipe: it is used to connect pressure monitoring instruments and related components. It is mainly composed of Ruhr connector and pipeline. Materials include medical grade PVC, polyethylene, polycarbonate, etc

14. Central venous catheter: used to monitor central venous pressure. The material is made of polyurethane and other materials

15. Variable temperature blanket: conduct conduction, convection and radiation through the contact part with the patient and within a certain space around the contact part. Its material is mostly PVC

16. Packaging: plastic bags usually made of polyethylene, polyethylene, unidirectional stretched polypropylene and dialysis paper

perfusion device

conclusion: facing the era of great development of life science in the 21st century, with the implementation of China's 11th five year plan, the development of medical plastics will become another pillar industry of China's national economy. Although the application of medical plastics in cardiopulmonary bypass in China started late, and compared with developed countries, we still have a certain gap. However, we are glad to see that medical plastics have made considerable development and progress in China in the past decade. Hope is tomorrow. As long as our insiders work hard and strive for self-improvement, the future of medical plastics will be better! The tomorrow of extracorporeal circulation will also be more brilliant

Author: Zhang Fuqiang, duanshutong, Gao Shan, Ma Li, Du Enhao, Tianjin Plastics Research Institute

original international plastics business information (end)

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