Domestic ecmo enters clinical stage
Domestic ecmo enters clinical stage This breakthrough is not a miracle from the sky, the cardiovascular team of the First Affiliated Hospital of Xi'an Jiaotong University, which has been engaged in the clinical application of ECMO and related researches for more than 20 years, has entered the clinical stage of the domestic ecmo.
Domestic ecmo entered the clinical stage1The First Affiliated Hospital of Xi'an Jiaotong University announced on the 8th that the extracorporeal membrane lung oxygenation device (ECMO) jointly developed by the hospital and the National Biomedical Materials Engineering and Technology Research Center of Sichuan University, and the School of Mechanics of Xi'an Jiaotong University, has taken the lead to enter the clinical stage in China.
ECMO can provide continuous extracorporeal respiration and circulation to patients with severe cardiopulmonary failure, winning valuable time for resuscitation. Since the outbreak of the new coronary pneumonia epidemic, ECMO has become more and more familiar to the public, however, its core technology has long been monopolized by foreign countries, and the price of equipment and consumables is expensive.
Yuan Zuyi, director of the Cardiovascular Hospital of the First Affiliated Hospital of Xi'an Jiaotong University, introduced that the cardiovascular team of the hospital has been engaged in the clinical application of ECMO and related research for more than 20 years. The team is one of the earliest units in China to carry out ECMO clinical work, and one of the earliest units in China to develop medical devices such as membrane oxygenators and perfusion tubing, etc. In 2017, the team, together with the relevant parties, launched an in-depth design and research and development of ECMO equipment for the whole blood contact surface of the long-lasting anticoagulant coating, magnetic levitation centrifugal pumps, ultrasonic flow probes, programmed monitoring systems, and ECMO membrane lungs.
Professor Zhuang Jian from the School of Mechanical Engineering at Xi'an Jiaotong University introduced that the R&D team has basically completed the trial production of samples of ECMO centrifugal pump equipment and a full range of consumables, and carried out large-animal experiments on anticoagulant coatings before the outbreak of the new coronary pneumonia epidemic. The first domestic ECMO system developed by the team was successfully applied in clinical practice.
China's ECMO has entered the clinical stage2
During the outbreak of the New Crown Epidemic, a large number of patients suffered from cardiopulmonary dysfunction, and ECMO played a huge role in the treatment, saving the lives of countless patients, and is now the standard in major hospitals in Europe and the United States.
ECMO is a powerful weapon to save patients with cardiopulmonary failure. Its main principle is to draw venous blood out of the body so that the blood is fully oxygenated with oxygen, and then pumped back into the body to replace the cardiopulmonary function, which can greatly help patients get through the most dangerous period of time when the patient is in critical condition.
As early as 1953, the first human artificial lung was born, and from the 1970s, ECMO was clinically applied in many hospitals in Europe and the United States, and in the 1990s, ECMO was really recognized and its medical value was recognized, and it began to be promoted to almost all the hospitals.
Before 2021, China's ECMO equipment is mainly imported from abroad, the unit price of a piece of equipment ranges from 1 million yuan to 3.5 million yuan, the price is not higher than many medical equipment imported from Japan, so the use of two weeks will cost the patient 200,000 yuan?
The reason is that the machine operation requires the corresponding consumables also belong to the foreign monopoly technology, which solid hollow fiber membrane in the world only one manufacturer, the price is very high, and another cutting-edge technology of ECMO is the centrifugal pump, which is also hindering the localization of China's one of the "hard bones".
Therefore, in China's third- and fourth-tier cities, as well as small and medium-sized hospitals, the popularity of this device is not very high, after all, there are really not many people who can afford it.
China's current ECMO equipment holdings are only about 500 units, there are currently more than 260 hospitals to support this treatment, combined with the actual number of people in China, the average of close to 2.8 million people have an ECMO device, and a hospital needs to cover the number of people as much as 5 million people, and in Germany, an ECMO covers the number of people for about 30,000 people, which is a huge digital divide. divide, the penetration rate in China is almost 1% of that in Germany.
Previously, due to the price of equipment and foreign monopolies, so the domestic equipment shortage, when the new crown epidemic broke out last year, the Ministry of Industry and Information Technology through the coordination of all parties, emergency recruitment and purchase, so that Hubei has more than 100 units of ECMO, but compared to the number of patients, the number of more or less a drop in the bucket.
Now that we have entered the post epidemic era, after the test during the epidemic, China has also recognized the importance of ECMO in guarding the safety of the people, coupled with the high price of foreign equipment, so the ordinary people of the domestic ECMO equipment is also more and more demanding.
Recently, on November 6, domestic ECMO devices were finally used in the clinic, and two doctors at the Cardiovascular Hospital of the First Affiliated Hospital of Xi'an Jiaotong University successfully treated two patients with critical cardiovascular diseases with domestic ECMO.
This domestic device into the clinical trial, in fact, not overnight has made such rapid progress, as early as 20 years ago, Xi'an Jiaotong University Hospital cardiovascular team has, and in the new crown epidemic before the start of the team has completed the ECMO centrifugal pump equipment and a full range of consumables samples of the trial production, and began to carry out the anticoagulant coating of the large animal experiments.
Under the pressure of the epidemic and the strong domestic demand for ECMO, the First Affiliated Hospital of Xi'an Jiaotong University accelerated its research and development, and after repeated trials and combining the actual clinical data of ECMO diagnosis and treatment in China, it finally succeeded in developing China's first set of ECMO system equipment and has a full set of independent intellectual property rights. Especially in the solid hollow fiber membrane, also achieved independent production capacity.
Currently, there are less than 1,300 cases of ECMO diagnosis and treatment per year in China, which is still a huge gap compared to the huge population base in China, and ECMO as a life-saving device, many hospitals want to use it, but can't, and the general public want to use it, but they can't afford to pay for the high price.
But these days may be gone, with the success of the clinical trials, the domestic ECMO equipment can be in accordance with the provisions of the large-scale production, and the domestic equipment in the price is obviously more advantageous, and the domestic equipment in the manufacture of the actual clinical situation in our country, which for the vast number of doctors and patients, is a very good news.
At the same time, due to the ECMO equipment in the international are highly monopolized, so as long as China's ECMO equipment formally approved, then it can be reversed to impact the international market, and the world in 2018 is only 12,000 people per year to accept the ECMO equipment diagnosis and treatment, so in the whole world, China's equipment also has a strong market potential!
It's exciting that China has broken the monopoly of the industry again, so how do you think domestic ECMO devices should be charged?
What is ECMO?
ECMO is Extracorporeal Membrane Pulmonary Oxygenation, which is known as an artificial lung, commonly known as the "Yeke Membrane", is a medical emergency device. As we all know, during the new crown of critically ill patients, often accompanied by cardiopulmonary failure, the device can provide patients with continuous extracorporeal respiration and circulation, to maintain life and extend the rescue time. ECMO in the new crown of the period, played an important role in the rescue of many people's lives.
ECMO is simply a modified artificial heart-lung machine, with a real core of membrane lungs and blood pumps that act as artificial lungs and artificial hearts, respectively. The main working principle is that the venous blood in the patient's body is drawn outside the body for oxygenation, and then the oxygenated blood is infused back into the body for oxygenation, thus temporarily replacing the cardiopulmonary function. It is this prolonged cardiopulmonary support for patients with severe cardiopulmonary failure, to win valuable time for critical care resuscitation, and race against death, is currently the most core support means for severe cardiopulmonary failure, known as the cardiopulmonary failure patients "the last straw".
ECMO a sound, gold ten thousand taels
and ECMO accompanied by the expensive price, ECMO this one machine is currently in the state of being monopolized, the domestic purely rely on imports, the imported ECMO equipment prices ranging from 1 million to 2 million. The machine itself, compared to other expensive medical equipment, seems to look less expensive.
But ECMO is also expensive in terms of consumables, with expenditures for ECMO disposable supplies, and individual kits costing tens of thousands of dollars, which usually need to be replaced during treatment. In addition, there is the use of medication, testing, equipment replacement costs, usually need to spend tens of thousands of yuan per day. A survey of post-cardiac ECMO patients at Guangdong Provincial People's Hospital showed that patients paid an average of more than 240,000 yuan after using ECMO.
In addition to the price of the machine itself and its consumables, there is also the high cost of healthcare operations, as ECMO is a technically difficult and risky life-saving technology, which means that it requires a high level of care from the treatment and nursing team, and often requires clinically experienced doctors and nurses from critical care, cardiovascular, and respiratory medicine to work together in a sophisticated way. This means that the use of ECMO requires the cooperation of multiple teams and comes with significant risks and high labor costs.
With expensive machines, expensive supplies, and expensive labor, it's no wonder that ECMO is so expensive.
30 years of monopoly
In 1953, a man named Gibbon invented the artificial heart-lung machine, and the technology was used for the first time in clinical cardiac surgery, and was also successful, and from then on the artificial heart-lung machine system has a long time auxiliary possibility. A series of developments followed, and as the level of medical technology, material technology, and mechanical technology continued to improve, the support time of ECMO continued to be extended. In the 1990s, ECMO was widely recognized and has been widely used in clinical critical care since then.
Our country lags a long way behind others in the field of ECMO, and started very late, not to mention what surpassed it. 30 years of monopoly, we not only buy expensive machines, but also expensive disposable consumables, and the solid hollow fiber membrane in ECMO is produced by only one manufacturer in the world, and the price is very high. The other thing that prevents us from developing our own ECMO is the centrifugal pump technology, which we have been unable to overcome.
Breaking the monopoly
Due to the monopoly and high price of equipment and consumables, ECMO equipment is very scarce in China. After the new crown, under the coordination of all parties, the ECMO equipment transferred to Hubei, but also more than 100 units, which can be seen in China on the shortage of ECMO equipment. Because of the important role played by ECMO devices during the epidemic, the public has also realized the importance of ECMO devices, and the heat about ECMO is getting higher and higher.
On November 6 of this year, the first extracorporeal membrane oxygenation device, ECMO, was developed by the First Affiliated Hospital of Xi'an Jiaotong University, the National Biomedical Materials Engineering Technology Research Center of Sichuan University, and the School of Mechanical Engineering of Xi'an Jiaotong University, and is the first ECMO device to be used in clinical practice in China. The team of Prof. Yuan Zuyi and Prof. Yan Yang from Cardiovascular Disease Center of the First Affiliated Hospital of Xi'an Jiaotong University successfully treated two critically ill cardiovascular patients using this domestic device. The successful use of domestic ECMO in the clinic breaks the monopoly of foreign countries in this field, which is very powerful.
This breakthrough is not a miracle, the cardiovascular team of the First Affiliated Hospital of Xi'an Jiaotong University has been engaged in the clinical application of ECMO and related research for more than 20 years, and it is one of the earliest teams in China to carry out clinical work on ECMO. In 2017 the team launched in-depth design and research and development for the ECMO device full blood contact surface long-lasting anticoagulation coating, magnetic levitation centrifugal pump, ultrasonic flow probe, programmed monitoring system and ECMO membrane lung. The ECMO system developed by the team is now successfully utilized in clinical practice, which is expected to significantly reduce the selling price of ECMO products in China, promote the development of ECMO in China's hospitals, benefit more critically ill patients, and protect the wallets of our ordinary people.
Currently, there are not many ECMO devices in China, and only 260 hospitals support this treatment method. Leaving aside the first and second tier cities, in the remaining small and medium-sized hospitals, the popularity of ECMO devices will not be too high, and in addition to the problem of expensive devices, there will not be too many people who can afford them.
We hope that the emergence of homegrown ECMO will improve this situation, but how do you think the pricing of ECMO should be priced?