PULM6: Evaluating The Influence Of Fibre Replacement And Configuration For The Development Of A Novel Artificial Lung Integrating Oxygenation And Hemofiltration Membrane Fibre Layers In A Single Deviceстатья из журнала
Аннотация: Introduction: Patients undergoing extracorporeal membrane oxygenation (ECMO) are at high risk of acute kidney injury and fluid overload. Up to 70% of ECMO patients suffer from AKI and half of them will require an additional renal replacement therapy. In the clinical setting, continuous renal replacement therapy (CRRT) is applied to provide renal support and fluid management for ECMO patients. However, so far, lung and kidney support are given by two separate devices, each requiring their own cannulas, pumps and tubing. Despite the frequent combination of ECMO and CRRT in intensive care units (ICUs), the use of separate circuits is not hemodynamically optimized and comprises additional foreign surfaces, increasing the risks of infection, heat loss and thrombus formation. The combination of lung and kidney support in a single device integrating oxygenation and hemofiltration fibres would offer a more sensible treatment reducing serious complications. We aim to develop a novel artificial lung with integrated renal support, which in the future could be utilized in ICUs for the treatment of critically-ill and end-stage lung disease patients with or without restricted kidney function. For that, in a first step, we analysed the number and configuration of oxygenation fibres, which could be replaced by hemofiltration fibres losing less than 10% of gas exchange capacity of a model oxygenator. Methods: Our device was designed for potting a specified number of oxygenator fibre layers (Oxyplus 3M™ Membrana™). Oxygenation fibre mats were cut to fit the device housing and placed perpendicularly on top of each other. The potting device was connected to a centrifuge, subjected to centrifugal forces and filled with silicone, creating membrane bundles with 55 fibre layers. The potted membranes had 25% or 50% of fibres layers closed by silicone, in a way that they did not contribute to gas exchange. The potted membrane bundles were inserted into a modular oxygenator housing and tested according to the ISO 7199 standard, see figure. In this way, the influence of replacing alternative oxygenation fibre layers by hemofiltration fibres on the gas exchange capacity of a prototype oxygenator was determined. Results: Preliminary analysis showed that fibre layers in an oxygenator partly contribute to gas exchange by deflecting blood flow, enhancing the mixing of blood cells. Based on these results we will determine how many oxygenation fibre layers can be substituted by hemofiltration fibres in our model oxygenator without losing more than 10% of its gas exchange capacity. Conclusions: Standardized blood tests reveal the influence of replacing oxygenation fibres in different numbers and configurations. Preliminary results suggest that multiple alternating oxygenation fibre layers could be replaced by hemofiltration fibres without an important loss of gas exchange capacity of the oxygenator.
Год издания: 2022
Авторы: Ana Martins Costa, Frank R. Halfwerk, Bettina Wiegmann, Jan‐Niklas Thiel, Michael Neidlin, Jutta Arens
Издательство: Lippincott Williams & Wilkins
Источник: ASAIO Journal
Ключевые слова: Mechanical Circulatory Support Devices
Другие ссылки: ASAIO Journal (HTML)
journals.lww.com (HTML)
journals.lww.com (HTML)
Открытый доступ: bronze
Том: 68
Выпуск: Supplement 2
Страницы: 87–87