DOI QR코드

DOI QR Code

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device

스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구

  • Park, Junhyun (Medical Engineering R&D Center, Asan Institute for Life Sciences, Asan Medical Center) ;
  • Ho, YeJi (Medical Engineering R&D Center, Asan Institute for Life Sciences, Asan Medical Center) ;
  • Lee, Yerim (Medical Engineering R&D Center, Asan Institute for Life Sciences, Asan Medical Center) ;
  • Lee, Duck Hee (Medical Engineering R&D Center, Asan Institute for Life Sciences, Asan Medical Center) ;
  • Choi, Jaesoon (Medical Engineering R&D Center, Asan Institute for Life Sciences, Asan Medical Center)
  • 박준현 (서울아산병원 아산생명과학연구원 의공학연구소) ;
  • 호예지 (서울아산병원 아산생명과학연구원 의공학연구소) ;
  • 이예림 (서울아산병원 아산생명과학연구원 의공학연구소) ;
  • 이덕희 (서울아산병원 아산생명과학연구원 의공학연구소) ;
  • 최재순 (서울아산병원 아산생명과학연구원 의공학연구소)
  • Received : 2019.07.17
  • Accepted : 2019.10.14
  • Published : 2019.10.31

Abstract

The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

Keywords

References

  1. Eugene A, Hessel II. History of cardiopulmonary bypass (CPB): Best Practice & Research Clinical Anaesthesiology. 2015; 29(2):99-111. https://doi.org/10.1016/j.bpa.2015.04.006
  2. Andreia Cristina Passaroni, Marcos Augusto de Moraes Silva, Winston Bonetti Yoshida. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine: Rev Bras Cir Cardiovasc. 2015;30(2):235-45. https://doi.org/10.5935/1678-9741.20150021
  3. David Zonies. ECLS in Trauma: Practical Application and a Review of Current Status: World Journal of Surgery. 2017;41(5):1159-64. https://doi.org/10.1007/s00268-016-3586-y
  4. ISO 7199:2016. Cardiovascular implants and artificial organs - Blood-gas exchangers (oxygenators).
  5. ISO 15676:2016. Cardiovascular implants and artificial organs - Requirements for single-use tubing packs for cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO).
  6. ISO 18242:2016. Cardiovascular implants and extracorporeal systems - Centrifugal blood pumps.
  7. ASTM F1841 - 97(2017). Standard Practice for Assessment of Hemolysis in Continuous Flow Blood Pumps.
  8. Medical assist device Evaluation Guidelines. 2010.
  9. Assessment Guidelines extracorporeal stationary continuous flow ventricular assist system. 2016.