發布時間:2023.01.10
1月8日,《環球時報》刊登航天長峰文章《China's first homegrown ECMO with full system makes impressive progress, to enter market in 2024》,同時首次獲《人民日報》西班牙語版轉載。
中文翻譯:
截至周五,綿羊托尼已經在心肺搭橋機的支持下生活了14天,這標志著首次研制全系統ECMO在動物試驗階段取得了巨大成功。
ECMO代表體外膜肺氧合,它從體外泵送和氧合患者的血液,使心臟和肺部得以休息。當患者出現心臟或肺衰竭時,通常在心內直視手術或肝、肺移植時使用ECMO。自2019年底新冠肺炎疫情在中國中部湖北省武漢市爆發以來,??松梨谥饾u贏得了中國“奇跡機器”的聲譽。在ECMO設備上存活下來的新冠肺炎危重患者的故事成為了頭版新聞。
然而,奇跡確實伴隨著巨大的代價,這通常是無法承受的。一臺進口ECMO機器的價格從100萬元人民幣(14.98萬美元)到350萬元人民幣。它包括一個由泵、管道、過濾器和監測器組成的復雜電路。據媒體報道,一般來說,兩周的治療費用可能高達20萬元。
試驗中的ECMO機器代號為ACM9000,由130多名中國科學家和研究人員在過去三年共同開發,北京航天長峰股份有限公司首席執行官蘇子華表示,這項中國國家重點研發項目(NKPs)于2021獲得科技部批準。
北航大學的科學家和研究人員以及中國醫學科學院阜外醫院、中國人民解放軍總醫院和北京大學第三醫院等一流醫院的醫學專家也參與了該項目。
蘇告訴《環球時報》記者:“經過長時間的成功動物試驗充分證明,我們(在開發ECMO方面)克服了所有技術障礙,我們正在努力進一步優化它?!?/span>
ACM9000 ECMO有望在2024年獲得正式臨床應用許可。在此之前,該模型將進行更多的動物試驗、臨床試驗以及倫理和數據檢查。
蘇透露,臨床試驗將在中國醫學科學院阜外醫院等中國最頂尖的醫院進行,這些醫院正面臨著新冠肺炎治療壓力的嚴峻挑戰。
當被問及為什么選擇一只羊作為實驗動物時,該項目的副負責人王亞偉表示,在全球范圍內開發ECMO設備時,使用羊是標準的。
ECMO動物試驗中的綿羊通常重達50至70公斤,這與成人的平均體重相似。更重要的是,綿羊的血液系統比人類更脆弱,更容易發生溶血。也就是說,如果一只羊能夠在ECMO的支持下存活一段時間,那么它對人類患者來說可能是安全的。
王強調,這是首次完全開發的全系統、全參數、長時支持的全鏈ECMO系統,其開發目的是救治心肺等器官衰竭的危重癥患者。從監視器、關鍵傳感器到泵、管道和過濾器等部件,ECMO完全由國內研發。
對綿羊的生命體征(包括紅細胞數量)的讀數表明,中國國產ECMO的關鍵部件——離心泵——與血液的相容性很好。
空氣-血液交換的關鍵部件——人造膜也取得了良好的效果。在這個過程中沒有出現血栓,血流阻力很低。
王說,ACM9000的性能與國外最先進的產品相當,在某些關鍵領域甚至更好。
蘇說,他預計在ACM9000正式進入市場后,費用可能會下降至少30%,從而大大節省中國患者的費用。
王指出,ECMO變得越便宜,實際應用的時間就越早,從而擴大了ECMO的使用范圍,增加了患者的生存機會?!芭c進口產品相比,我們的目標是大幅減少患者在ECMO上的支出?!?/span>
北航大學的科學家陳增勝告訴《環球時報》記者:“開發ECMO很復雜,因為它涉及幾十個部分。然而,我們已經設法在每個部分實現了優化。(動物試驗的)結果比我們預期的要好?!标?/span>博士擁有人工器官領域的研究背景,并于2019年回國后加入了中國ECMO研發項目。
根據陳的說法,除了ECMO民用外,中國科學家還在考慮將ECMO的工作場景擴展到戰場。為了滿足軍事用途的要求,科學家們還致力于確保ECMO在低溫和高原環境中的性能,縮小機器的尺寸是他們的目標之一。
英文原文:
Head: First homegrown ECMO system makes impressive progress
By Deng Xiaoci
Tony the sheep had been living with the support of a heart-lung bypass machine for 14 days as of Sunday, marking a big success in the animal testing phase for first-ever whole-system ECMO development.
ECMO stands for extracorporeal membrane oxygenation, which pumps and oxygenates a patient's blood from outside the body, allowing the heart and lungs to rest. It is used when a patient has heart or lung failure and often during open-heart surgery, or liver and lung transplants. ECMO has gradually earned its reputation of being a “miracle machine” in China since the COVID-19 epidemic broke out in Wuhan, Central China’s Hubei Province at the end of 2019. Stories of critically ill COVID-19 patients who survived on ECMO devices made front-page news.
However, the miracles do come with a big price, which is generally unaffordable. An imported ECMO machine is priced from 1 million yuan ($149,800) to 3.5 million yuan. It includes a complex circuit of pumps, tubes, filters and monitors. Generally, the cost of two weeks of treatment could be as much as 200,000 yuan, according to media reports.
The ECMO machine on trial is codenamed ACM9000, and has been jointly developed by more than 130 Chinese scientists and researchers in the past three years, said Su Zihua, CEO of Beijing Aerosapce Changfeng Co., Ltd. , which were approved by the Ministry of Science and Technology in 2021.
Scientists and researchers from Beihang University and medical experts with top-notch hospitals such as Fuwai Hospital of the Chinese Academy of Medical Sciences, the Chinese People's Liberation Army General Hospital and Beijing University Third Hospital have also participated in the project.
“The successful animal testing with a prolonged testing period fully demonstrates that we have overcome all the technological barriers [in developing ECMO] and we are now working to further optimize it,” Su told the Global Times.
The ACM9000 ECMO is expected to attain the license for formal clinical application by 2024. Before that, the model will undergo more animal testing, clinical trials and ethical and data examination.
Clinical trials will be carried out in Fuwai Hospital of the Chinese Academy of Medical Sciences, the Chinese People's Liberation Army General Hospital and Beijing University Third Hospital, which are facing the gravest challenge from COVID-19 treatment pressure, Su revealed.
When asked why a sheep was picked as the experiment animal, Wang Yawei, the deputy chief of the project, said that it is standard to use sheep when developing ECMO devices worldwide.
The sheep in ECMO animal tests usually weigh 50 to 70 kilograms, which is similar to an adult human being on average. More importantly, the sheep’s blood system is more vulnerable than in humans, with hemolysis more likely to develop. That is to say, if a sheep can survive for a certain period with the support of ECMO, it would probably be safe for human patients, Wang said.
This is the first time that a full-chain ECMO system has been wholly developed, and the development aims to combat the COVID-19 epidemic, Wang stressed. From the monitors, key sensors, to parts including pumps, tubes and filters, the ECMO is completely domestically developed.
Reading of the sheep’s vitals including the amount of red blood cells has shown that the key component of the Chinese homegrown ECMO – the centrifugal pump — shows outstanding compatibility with blood.
There were also good results with the key component for air-blood exchange, the artificial membrane. No blood clots developed in the process and the resistance in the blood flow was low.
The ACM9000 has shown performance comparable to the most advanced foreign products, and in some key areas it is even better, Wang said.
Su said he expected that the cost could fall by at least 30 percent after the ACM9000 officially enters the market, greatly saving expenses for Chinese patients.
Due to the hefty price, the machine is only used at the very end of the medical treatment. The cheaper the ECMO becomes, the sooner it could actually be adopted, expanding the scope of the ECMO use and increasing the chance of survival for patients, Wang noted. “Our goal is to greatly reduce the patient’s spending on ECMO compared to an imported product.”
“It is complicated to develop ECMO as it involves dozens of parts. However, we have managed to achieve optimization at every part. And the result [of the animal testing] is better than what we expected,” Chen Zengsheng, a scientist from Beihang University, told the Global Times. Chen has a background of research in the field of artificial organs oversees and joined the Chinese ECMO R&D project after coming back to China in 2019.
According to Chen, apart from the civilian use of ECMO, Chinese scientists are also mulling expanding the working scenario for ECMO to the battlefield. To meet military use requirements, the scientists are also working to ensure ECMO performance in low-temperature and plateau environments, and downsizing the machine is one of their goals.
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