Comparison of a New Heparin‐coated Dense Membrane Lung with Nonheparin‐coated Dense Membrane Lung for Prolonged Extracorporeal Lung Assist in Goats

Abstract

Thrombosis and bleeding are major complications in cases of prolonged extracorporeal lung assist (ECLA) with an artificial-membrane lung. Antithrombogenic treatment of the artificial-membrane oxygenator and circuits is indispensable for safe ECLA. The efficacy of a new heparin-coated membrane lung with minimal systemic heparinization was evaluated for 7 days and compared with a nonheparin-coated membrane lung in goats. The animals were randomly assigned to either the heparin-coated membrane group (HM group, n = 5) or nonheparin-coated membrane group (NHM group, n = 5). Activated coagulation time (ACT) during ECLA was controlled to below 150 s in the HM group, and to near 200 s in the NHM group. All goats in the HM group were sustained on ECLA for 7 days, but two goats in the NHM group died on the 4th and 6th days, respectively. The mean systemic administration rate of heparin during ECLA was 22.4 +/- 4.4 U/kg/h in the HM group and 39.0 +/- 10.0 U/kg/h in the NHM group. There was a significant difference between the two groups (P < 0.05). The oxygen transfer rate, the Pco(2) difference, the perfusion resistance, and platelet counts showed no significant changes. There was no plasma leakage from the artificial lung. Although several clots were observed in the stagnant areas of the artificial lung, they did not lead to deterioration of the function of the artificial lung. The excellent antithrombogenicity, gas exchange ability, and durability of this new artificial lung with circuits might contribute to successful prolonged ECLA with minimal systemic heparinization.

Computational Study of the Blood Flow in Three Types of 3D Hollow Fiber Membrane Bundles

“…Usually, very low shear stresses may lead to the platelet adhesion and blood clot to fiber walls [37]. On the other hand, high shear stresses could induce the platelet activation and even hemolysis, which can decrease gas exchange capacities and affect device performance.…”

New Trends, Advantages and Disadvantages in Anticoagulation and Coating Methods Used in Extracorporeal Life Support Devices

“…Heparin-coated systems for ECLS were developed to reduce the hemorrhagic risk by lowering the systemic heparinization [ 62 , 63 , 64 , 65 ]. The first heparin coating to become commercially available was developed by the company Carmeda in 1983 [ 66 , 67 ].…”

Conduite et complications de l’oxygénation extracorporelle veinoveineuse

“…Les circuits couverts soit d'héparine, soit d'autres agents chimiques (phosphorylcholine, poly2méthoxyéthyl acrylate, etc.) semblent diminuer l'intensité des interactions sang/ biomatériaux, et ils permettent, si des saignements importants apparaissent, de diminuer, voire d'arrêter l'anti coagulation systémique avec des risques limités de formation de throm bus pour autant que le débit dans le circuit ne soit pas trop faible [11,12]. À moins d'avoir eu le temps de remplir le circuit avec du sang, il faut s'attendre à une chute significative de l'héma tocrite suite à l'hémodilution par le liquide de remplissage et, donc, à la nécessité de transfuser le patient.…”