Description of a Flow Optimized Oxygenator With Integrated Pulsatile Pump

Extracorporeal membrane oxygenation (ECMO) is rarely utilized in patients with severe pulmonary hypertension (PH) as a bridge to lung transplantation. In this study we assess the blood biocompatibility of the integrated Centrimag® Novalung ® ECMO system (veno arterial) in an acute model of PH. Severe PH (≥ 2/3 systemic) was induced in eight ovines through progressive ligation of the main pulmonary artery. System performance, platelet activation, thromboelastography parameters, fibrinogen, plasma free hemoglobin, and total plasma protein were measured at initiation, 3 and 6 hrs of support in the ECMO (N=4) and sham (N=4) groups. A stable ECMO flow (2.2 ± 0.1 L/min), low trans-membrane pressure gradient and steady blood O2 and CO2 levels were maintained. Platelet activation was low (< 4%) in both the groups whereas platelet responsiveness to agonist (platelet activating factor) was reduced in the sham group when compared to the ECMO group. There were no differences in the TEG parameters, fibrinogen concentration, plasma free hemoglobin (< 10 mg/dL) and plasma total protein between the two groups. The findings of low levels of platelet activation and plfHb suggest adequate blood biocompatibility of the integrated Centrimag® Novalung® circuit use for short term support in a model of PH.

Section: Discussionmentioning

confidence: 99%

Biocompatibility Assessment of the CentriMag-Novalung Adult ECMO Circuit in a Model of Acute Pulmonary Hypertension

Shankarraman¹,

Koçyıldırım²,

Olia³

et al. 2014

“…46 In this experiment, a slight to moderate hemolysis occurred induced by the ExMeTrA oxygenator using an integrated pulsatile pump by collapsing and expanding silicone tubes placed in the fiber bundle in combination with active valves. 20,39,47,48 In conclusion, our study analyzed the feasibility and hemocompatibility of a novel pediatric oxygenator with integrated Figure 4: Blood flow stayed stable over the time of ECC. Blood flow was measured using a flow meter behind the ExMeTrA oxygenator at the beginning of the ECC and after 1, 5, 10, 20, 30, 60, 120, 270, and 360 min.…”

Section: Figurementioning

confidence: 93%

“…This was achieved by embedding thin-walled silicone tubes collapsing and expanding into the bundles. [20][21][22][23] This ExMeTrA system can offer multiple advantages compared with conventional systems, such as minimal filling volume (27 ml), suitable for ECMO in neonatology, compact and combined design (integrated pump), short tubing routes to the patient, and a pulsatile flow.…”

mentioning

confidence: 99%

First In Vivo Results of a Novel Pediatric Oxygenator with an Integrated Pulsatile Pump

Stang

Borchardt²,

Neumann

et al. 2015

Self Cite

Extracorporeal membrane oxygenation (ECMO) is a pivotal bridge to recovery for cardiopulmonary failure in children. Besides its life-saving quality, it is often associated with severe system-related complications, such as hemolysis, inflammation, and thromboembolism. Novel oxygenator and pump systems may reduce such ECMO-related complications. The ExMeTrA oxygenator is a newly designed pediatric oxygenator with an integrated pulsatile pump minimizing the priming volume and reducing the surface area of blood contact. The aim of our study was to investigate the feasibility and safety of this new ExMeTrA (expansion mediated transport and accumulation) oxygenator in an animal model. During 6 h of extracorporeal circulation (ECC) in pigs, parameters of the hemostatic system including coagulation, platelets and complement activation, and flow rates were investigated. A nonsignificant trend in C3 consumption, thrombin-antithrombin-III (TAT) complex formation and a slight trend in hemolysis were detected. During the ECC, the blood flow was constantly at 500 ml/min using only flexible silicone tubes inside the oxygenator as pulsatile pump. Our data clearly indicate that the hemostatic markers were only slightly influenced by the ExMeTrA oxygenator. Additionally, the oxygenator showed a constant quality of blood flow. Therefore, this novel pediatric oxygenator shows the potential to be used in pediatric and neonatal support with ECMO.

“…The major improvements in the manufacturing technique used to generate the modules as compared with the previous published version 19 was the usage of a central core in the fiber bundle as well as the intended tubular arrangement. With regard to the priming volume, the use of a centrifuge to seal the fiber bundle achieved better consistency between different modules.…”

Section: Manufacturingmentioning

confidence: 99%

“…8 It has been assumed that the number of ECMO applications would increase if the therapy is optimized in terms of simplified usage and design adjustments to components that are developed specifically for this therapy. 19 In contrast to solutions with a rotary pump, this method enables Often the major challenges with ECMO circuits are associated with minimizing priming volume and surface area of blood contacting surfaces.…”

mentioning

confidence: 99%

In Vitro Performance Testing of a Pediatric Oxygenator With an Integrated Pulsatile Pump

Borchardt¹,

Schlanstein²,

Mager³

et al. 2012

Self Cite

For different lung and heart diseases (e.g., acute respiratory distress syndrome, congenital heart failure, and cardiomyopathy) extracorporeal membrane oxygenation is a well-established therapy, particularly in the field of neonatal and pediatric medicine. To reduce the priming volume of the extracorporeal circuit, different components can be combined. In this study, an oval-shaped oxygenator (called ExMeTrA) with integrated pulsatile pump was tested in vitro using porcine blood. A feasibility study regarding the performance of collapsing and expanding silicone tubes within an oxygenator fiber bundle as a pulsatile pump was previously completed with successful results. The findings of this study improve upon the previous feasibility results, particularly in terms of gas exchange and filling volume. Five modules were manufactured in sizes of 20 ± 2.2 ml (priming volume) with fiber surface areas of 0.24 ± 0.027 m(2) and an analytically calculated volume pumping capacity of 692 ± 75 ml/min. The modules were made of polymethylpentene fibers with dense outer layer to permit long-term applications. The gas exchange rates at a gas/blood flow ratio of 2:1 were between 64 and 72.7 ml(O)(2)/l(blood) and between 62.5 and 81.5 ml/l(blood), depending on the blood flow. The individual module's pumping capacity ranged from 200-500 ml/min thus providing room for further improvements. In order to enhance the pumping capacity while maintaining sufficient gas exchange rates future optimization, adjustments will be made to the inlet and outlet geometries.