ASAIO GOLD

The 25 Landmark ‘Milestone’ Papers Published by ASAIO

1955-2003

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Artificial Endocrine Organs

1. Rohde TD, Blackshear PJ, Varco RL, Buchwald H, "Protracted parenteral drug infusion in ambulatory subjects using an implantable infusion pump," Trans Am Soc Artif Intern Organs 23: 13-16, 1977.

Commentary: This group,from the University of Minnesota and Mass.Gen.Hospital, made the first clinical report of the use of an implanted drug delivery system at the 1977 ASAIO Meeting in Montreal. It detailed the use of the device to deliver continuous heparin at a predetermined dose to 11 patients with recurrent thromboembolic problems for periods up to 1 year and the technique allowed the patients to be managed in an outpatient setting. Their success occurred 7 years after the initial experimental paper. This group went on to expand the use of the device to insulin infusion for diabetics and chemotherapy infusion for malignancies. – Leonard Golding, MD

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Commentary: This landmark paper presented in 1977 describes a remarkable pump designed by Henry Buchwald and Perry Blackshear which became the prototype pump mechanism for continuous infusion of hormones, medications, and chemotherapeutic drugs for the next several decades. Although the continuous infusion of insulin is and was a perfect way to control the swings in blood sugar associated with diabetes, the patient had to maintain quite a stable carbohydrate intake in order to avoid hypoglycemia, so this method of management of severe diabetes did not develop into a standard treatment because of the problems of sensing blood glucose and servo-regulating the pump infusion rate based on measured glucose. However, the concept of a continuous infusion pump powered by compression of a gas to a liquid below a flexible diaphragm is a superb example of bioengineering. – Robert Bartlett, MD

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