A prototype of a liquid ventilator using a novel hollow-fiber oxygenator in a rabbit model

Abstract

These data demonstrate the ability of this novel single-piston, nonporous hollow silicone fiber oxygenator to adequately support gas exchange, allowing successful performance of total liquid ventilation.

A Liquid Ventilator Prototype for Total Liquid Ventilation Preclinical Studies

“…Results in the present and previous (Avoine et al, 2011;Beaudry 2009;Robert et al 2010) studies show that our custom-designed bubble oxygenator can oxygenate PFC at a level up to Fi PFC O 2 =96%, which is similar to previously published data obtained with a silicone hollow fiber membrane oxygenator in rabbits (93%, when considering a standard atmospheric pressure of 760 mmHg) (Tredici et al, 2004) or commercial membrane oxygenator (84%) (Cox et al, 2003;Stavis et al, 1998). In addition, the maximal PaO 2 of 234 mmHg obtained herein is similar to the PaO 2 value of 201 mmHg previously reported in healthy newborn lambs by others (Hirschl et al, 1995;Larrabe et al, 2001;Stavis et al, 1998, www.intechopen.com Progress in Molecular and Environmental Bioengineering -From Analysis and Modeling to Technology Applications 336 Cox et al 2003).…”

“…Reduction of gas flow to the oxygenator decreases the oxygenator efficiency index, with the most undesirable effect being the deterioration of the CO 2 removal before any effect on PaO 2 reduction. Similar results, on the high flow rate requirement in order to achieve an efficient CO 2 removal, were previously reported with a hollow-fiber oxygenator in a rabbit model (Tredici et al, 2004). Finally, as expected, our method based on the control of F gas O 2 with a gas mixer enabled us to adjust Fi PFC O 2 and consequently to control PaO 2 down to safer values without significantly altering PaCO 2 and pH.…”

“…However, the insertion of a pressure sensor in the mouth can be problematic in a clinical context, thus the main issue is to adapt this pressure controlled mode without a pressure sensor in the trachea. Many efficient demonstrations of TLV have been performed with different prototypes (Corno et al 2003;Cox et al 2003;Degraeuwe et al, 2000a;Hirschl et al, 1995;Larrabe et al, 2001;Meinhardt et al, 2000;Parker et al, 2009;Pohlmann et al, 2011;Sekins et al, 1999;Tredici et al, 2004). With O 2 saturated PFC and limited to low minute ventilations (comparatively to CMV), they obtained acceptable ventilation.…”

“…Research teams in TLV have mainly used bubble oxygenators Sekins et al, 1999;Tissier et al, 2009), commercial membrane oxygenators (Corno et al 2003;Larrabe et al, 2001;Hirschl et al, 1995;Wolfson et al, 1999Wolfson et al, , 2008 or have developed membrane oxygenators specifically for TLV (Tredici et al, 2004). However, the requirements for extracorporeal blood oxygenation appear irrelevant in TLV, since there is no mechanical stress to the blood (hemolysis) or bubble infusion in the blood (Iwahashi et al, 2004).…”

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

“…9,15,16 This would be of importance as several prototypes of total liquid ventilators have been developed and may be used in adults after technical improvements. 17,18 By the present time, no clinical reports have properly investigated cooling using TLV in humans but several studies have tested other cooling strategies such as external or endovascular cooling. The first large scale clinical trial implementing cooling in the treatment of myocardial infarction was done using endovascular cooling devices in the COOL-MI and ICE-IT-1 studies.…”