In vitro and in vivo evaluation of a novel integrated wearable artificial lung

Madhani, Shalv P.; Frankowski, Brian J.; Burgreen, Greg W.; Antaki, Jim F.; Kormos, Robert L.; D’Cunha, Jonathan; Federspiel, William J.

doi:10.1016/j.healun.2017.02.025

Cited by 32 publications

(29 citation statements)

References 23 publications

(32 reference statements)

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“…This prototype device weighs 1850 g and is intended to have the option to be worn by the patient. The specific design and manufacturing details of the LF-PAL devices have been previously published [ 22 ]. The device has previously been evaluated for high-flow adult oxygenation [ 22 ], but not for low-flow CO 2 removal.…”

Section: Methodsmentioning

confidence: 99%

Bench Validation of a Compact Low-Flow CO2 Removal Device

May

Jeffries

Frankowski

et al. 2018

ICMx

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BackgroundThere is increasing evidence demonstrating the value of partial extracorporeal CO2 removal (ECCO2R) for the treatment of hypercapnia in patients with acute exacerbations of chronic obstructive pulmonary disease and acute respiratory distress syndrome. Mechanical ventilation has traditionally been used to treat hypercapnia in these patients, however, it has been well-established that aggressive ventilator settings can lead to ventilator-induced lung injury. ECCO2R removes CO2 independently of the lungs and has been used to permit lung protective ventilation to prevent ventilator-induced lung injury, prevent intubation, and aid in ventilator weaning. The Low-Flow Pittsburgh Ambulatory Lung (LF-PAL) is a low-flow ECCO2R device that integrates the fiber bundle (0.65 m2) and centrifugal pump into a compact unit to permit patient ambulation.MethodsA blood analog was used to evaluate the performance of the pump at various impeller rotation rates. In vitro CO2 removal tested under normocapnic conditions and 6-h hemolysis testing were completed using bovine blood. Computational fluid dynamics and a mass-transfer model were also used to evaluate the performance of the LF-PAL.ResultsThe integrated pump was able to generate flows up to 700 mL/min against the Hemolung 15.5 Fr dual lumen catheter. The maximum vCO2 of 105 mL/min was achieved at a blood flow rate of 700 mL/min. The therapeutic index of hemolysis was 0.080 g/(100 min). The normalized index of hemolysis was 0.158 g/(100 L).ConclusionsThe LF-PAL met pumping, CO2 removal, and hemolysis design targets and has the potential to enable ambulation while on ECCO2R.

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Section: Methodsmentioning

confidence: 99%

Bench Validation of a Compact Low-Flow CO2 Removal Device

May

Jeffries

Frankowski

et al. 2018

ICMx

Self Cite

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“…9). 44 The stacktype fiber bundles and the impellers with embedded magnets allow the miniaturized profile. In vitro and in vivo testing has demonstrated that the paracorporeal ambulatory assist lung generated flows of 3.5 L/min at rotational speed of 2,100 revolutions/min and provided sufficient O 2 and CO 2 transfer.…”

Section: Wearable Ecmomentioning

confidence: 99%

Technical Advances in the Field of ECMO

Betit¹

2018

Respir Care

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Although the fundamentals of extracorporeal membrane oxygenation (ECMO) have not changed in 3 decades, the technical elements continue to improve and have evolved from an assemblage of individual components to more integrated systems with added features, enhanced safety, and improved maneuverability. The introduction of polymethylpentene (PMP) fiber technology has expanded the development of artificial membranes that have low resistance, are more biocompatible, and can be used for extended durations. Extracorporeal carbon dioxide removal techniques continue to be enhanced as stand alone technology and modified renal dialysis systems are introduced. Research continues in the development of compact and wearable artificial lungs that are intended to support patients for prolonged periods (eg, patients awaiting lung transplantation). The use of high-fidelity simulation training has become a standard and important method for reinforcing technical skills, refining troubleshooting sequences, and enhancing team interactions. Modifications to mannequins and ECMO systems coupled with clinical and physiologic scenarios will help achieve greater realism and enhance learning. ECMO technology continues to improve, with adaptability and versatility being essential attributes.

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“…Risk and complications can be substantially alleviated by integrating the pump and oxygenator together into one device 75 . The Pittsburgh Ambulatory Assist Lung (PAAL) is based on oxygenation efficiency modeled as a function of fiber bundle diameter 20,74 . Using the model, a 1.75‐mm‐diameter bundle with a 0.65‐m surface area was predicted to produce oxygenation of 180 mL/min at blood flow rate of 3.5 L/min.…”

Section: Wearable Artificial Lung Systems Allow For Ambulationmentioning

confidence: 99%

Artificial lungs––Where are we going with the lung replacement therapy?

et al. 2020

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Lung transplantation may be a final destination therapy in lung failure, but limited donor organ availability creates a need for alternative management, including artificial lung technology. This invited review discusses ongoing developments and future research pathways for respiratory assist devices and tissue engineering to treat advanced and refractory lung disease. An overview is also given on the aftermath of the coronavirus disease 2019 pandemic and lessons learned as the world comes out of this situation. The first order of business in the future of lung support is solving the problems with existing mechanical devices. Interestingly, challenges identified during the early days of development persist today. These challenges include device‐related infection, bleeding, thrombosis, cost, and patient quality of life. The main approaches of the future directions are to repair, restore, replace, or regenerate the lungs. Engineering improvements to hollow fiber membrane gas exchangers are enabling longer term wearable systems and can be used to bridge lung failure patients to transplantation. Progress in the development of microchannel‐based devices has provided the concept of biomimetic devices that may even enable intracorporeal implantation. Tissue engineering and cell‐based technologies have provided the concept of bioartificial lungs with properties similar to the native organ. Recent progress in artificial lung technologies includes continued advances in both engineering and biology. The final goal is to achieve a truly implantable and durable artificial lung that is applicable to destination therapy.

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In vitro and in vivo evaluation of a novel integrated wearable artificial lung

Cited by 32 publications

References 23 publications

Bench Validation of a Compact Low-Flow CO2 Removal Device

Bench Validation of a Compact Low-Flow CO2 Removal Device

Technical Advances in the Field of ECMO

Artificial lungs––Where are we going with the lung replacement therapy?

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