3．体外循環と人工心肺回路

The Management Methods for Cardiopulmonary Bypass and Control Features in the Modern Heart-lung Machines

この十数年，人工心肺領域には目立った発展が認められていないように思われがちであるが，凝固管理戦略や人工心肺中の酸素供給量指数（DO2i），二酸化炭素（CO2）由来のパラメータを活用した灌流量の調整といった人工心肺を管理するうえでの考え方には，進歩が認められている．また，人工心肺装置にも新しい機能が搭載され始め，操作性や人工心肺管理中の安全性は向上していると考えられる．本稿では，人工心肺管理における考え方や人工心肺装置の制御機能の進歩について概説する．

While it may seem that there have been no significant changes in the field of cardiopulmonary bypass （CPB） over the past decade, there have been advances in management concepts, such as coagulation management strategies and the use of oxygen delivery index （DO2i） and carbon dioxide （CO2）-derived variables during CPB. It will be important to examine what changes in outcomes are observed as a result of advances in management methods. The development of a variety of monitoring devices is expected if better outcomes are observed as a result of advances in CPB management. In addition, the introduction and study of different perfusion-assist functions are hoped to lead to the automation of operations in CPB.