Clinical Trials of an Intravenous Oxygenator in Patients with Adult Respiratory Distress Syndrome

High, Kane M.; Snider, Michael T.; Richard, Russell; Russell, Garry B.; Stene, John K.; Campbell, David B.; Aufiero, Thomas X.; Thieme, Gary A.

doi:10.1097/00000542-199211000-00004

Cited by 53 publications

(20 citation statements)

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“…19,20 Early clinical trials of the IVOX in critically ill patients revealed that approximately 25-30% of basal respiratory requirements were achievable, yielding distinct clinical benefit for select patients. [21][22][23][24][25][26] Further technical advances included modifications of fiber material to enhance gas exchange and the incorporation of pumps to promote active mixing. [27][28][29][30][31] In 1994, Conrad et al 32 summarized the findings of a large multinational database, in which 164 IVOX devices were evaluated in 160 patients who were symptomatic while receiving conventional ventilator support for respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

Development of a Photolytic Artificial Lung: Preliminary Concept Validation

Dasse

Monzyk²,

Burckle³

et al. 2003

ASAIO Journal

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There is an established need for pulmonary technology capable of facilitated gas exchange in the blood, thereby bypassing the alveolar-capillary interface. To address this need, we emulated one of the best-known photolytic reactions in nature, photosynthesis, in which green plants use sunlight to drive the exchange of oxygen for carbon dioxide. Our goal in the current study was to demonstrate the feasibility of direct photolytic conversion of water to liquid phase oxygen (dissolved oxygen [DO]) in synthetic serum. To this end, we constructed a test flow cell consisting of a conductive coating of vacuum-deposited titanium (Ti) metal, adherent TiO2 (anatase), and MnO2, applied as a laminate to a glass substrate, and then immersed the device in Locke's-Ringer solution (synthetic blood serum). Long wavelength (low energy) ultraviolet A laser light, directed to the transparent glass slide, reproducibly resulted in the generation of an active form of oxygen (AO), which was subsequently converted directly by the catalytic action of MnO2 to DO. The absence of light activation provided an entirely null response. We conclude that the photolytic production of DO from water in a blood serum surrogate, with commensurate CO2 clearance, is feasible. A prototype photolytic module is proposed, which uses multiple parallel photolytic surfaces to improve system production capacity and CO2 clearance through selective gas-liquid separation from the oxygen-enriched fluid.

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Section: Discussionmentioning

confidence: 99%

Development of a Photolytic Artificial Lung: Preliminary Concept Validation

Dasse

Monzyk²,

Burckle³

et al. 2003

ASAIO Journal

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“…6,7 The intravenous respiratory assist device introduced by Mortensen proceeded onto human clinical testing in the 1990s as the IVOX and demonstrated general feasibility for the concept of an intravenous respiratory assist device. [3][4][5]8,9 Nevertheless, issues with clinical trial design, the size of the IVOX (33.3F to 45F), 10 and the IVOX level of gas exchange halted further development of the IVOX.…”

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confidence: 99%

Evaluation of Fiber Bundle Rotation for Enhancing Gas Exchange in a Respiratory Assist Catheter

Eash¹,

Mihelc²,

Frankowski³

et al. 2007

ASAIO Journal

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Supplemental oxygenation and carbon dioxide removal through an intravenous respiratory assist catheter can be used as a means of treating patients with acute respiratory failure. We are beginning development efforts toward a new respiratory assist catheter with an insertional size <25F, which can be inserted percutaneously. In this study, we evaluated fiber bundle rotation as an improved mechanism for active mixing and enhanced gas exchange in intravenous respiratory assist catheters. Using a simple test apparatus of a rotating densely packed bundle of hollow fiber membranes, water and blood gas exchange levels were evaluated at various rotation speeds in a mock vena cava. At 12,000 RPM, maximum CO2 gas exchange rates were 449 and 523 mL/min per m2, water and blood, respectively, but the rate of increase with increasing rotation rate diminished beyond 7500 RPM. These levels of gas exchange efficiency are two- to threefold greater than achieved in our previous respiratory catheters using balloon pulsation for active mixing. In preliminary hemolysis tests, which monitored plasma-free hemoglobin levels in vitro over a period of 6 hours, we established that the rotating fiber bundle per se did not cause significant blood hemolysis compared with an intra-aortic balloon pump. Accordingly, fiber bundle rotation appears to be a potential mechanism for increasing gas exchange and reducing insertional size in respiratory catheters.

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“…In humans, the maximal gas transfer reported is 84 ml·min -1 for O 2 and 82 ml·min -1 for CO 2 with an extreme variability between individuals [7]. In addition, any amelioration due to the IVOX rarely allows ventilatory parameters to be reduced [8].…”

Section: Discussionmentioning

confidence: 99%

IVOX in ARDS: respiratory effects and serious complications

Gasche

Romand²,

Prêtre³

et al. 1994

Eur Respir J

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I IV VO OX X i in n A AR RD DS S: : r re es sp pi ir ra at to or ry y e ef ff fe ec ct ts s a an nd d s se er ri io ou us s c co om mp pl li ic ca at ti io on ns s IVOX in ARDS: respiratory effects and serious complications. Y. Gasche, J.A. Romand, R. Prêtre, P.M. Suter. ERS Journals Ltd 1994. ABSTRACT: We describe the beneficial effects of an intravenous oxygenator (IVOX) on ventilatory pressure requirement, and also several severe complications related to its use in a young trauma victim developing severe acute respiratory distress syndrome (ARDS).In this patient, adequate systemic oxygenation could not be maintained despite the use of fractional inspired oxygen of 1.0, high level positive end-expiratory pressure (PEEP), and nitric oxide inhalation (30 ppm). The introduction of an intravenous oxygenator improved arterial oxygenation and CO 2 elimination, allowing a decrease in minute ventilation and airway pressure. However, hepatic cytolysis, acute renal dysfunction and iliac vein thrombosis developed concomitantly, in spite of full anticoagulation with heparin. These complications resolved rapidly after removal of the IVOX device and the patient made a good recovery.

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Clinical Trials of an Intravenous Oxygenator in Patients with Adult Respiratory Distress Syndrome

Cited by 53 publications

References 0 publications

Development of a Photolytic Artificial Lung: Preliminary Concept Validation

Development of a Photolytic Artificial Lung: Preliminary Concept Validation

Evaluation of Fiber Bundle Rotation for Enhancing Gas Exchange in a Respiratory Assist Catheter

IVOX in ARDS: respiratory effects and serious complications

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