Extracorporeal Respiratory Support With a Miniature Integrated Pediatric Pump‐Lung Device in an Acute Ovine Respiratory Failure Model

Abstract

Purpose Respiratory failure is one of the major causes of mortality and morbidity all over the world. Therapeutic options to treat respiratory failure remain limited. The objective of this study was to evaluate the gas transfer performance of a new newly developed miniature portable integrated pediatric pump-lung device (PediPL) with small membrane surface for respiratory support in an acute ovine respiratory failure model. Methods The respiratory failure was created in six adult sheep using intravenous anesthesia and reduced mechanical ventilation at 2 breaths/min. The PediPL device was surgically implanted and evaluated for respiratory support in a veno-veno configuration between the right atrium and pulmonary artery. The hemodynamics and respiratory status of the animals during support with the device gas transfer performance of the PediPL were studied for four hours. Results The animals exhibited respiratory failure after 30 minutes after mechanical ventilation was reduced to 2 breaths/min, indicated by low oxygen partial pressure, low oxygen saturation and elevated carbon dioxide in arterial blood. The failure was reversed by establishing respiratory support with the PediPL after 30 minutes. The rates of O2 transfer and CO2 removal of the PediPL were 86.8 ml/min and 139.1 ml/min, respectively. Conclusions The results demonstrated that the PediPL (miniature integrated pump-oxygenator) has the potential to provide respiratory support as a novel treatment of both hypoxia and hypercarbia. The compact size of the PediPL could allow portability and potentially be used in many emergency settings to rescue patients suffering acute lung injury.

Technical Advances in the Field of ECMO

“…Additional experiments with the pediatric pump-lung were conducted in a sheep model of acute respiratory failure to further evaluate the gas-exchange capabilities. 43 Respiratory failure was induced in 6 animals after placement of the pediatric pump-lung. As soon as hypoxemic and hypercapnic indices of respiratory failure were attained and changes in hemodynamic parameters occurred, blood and sweep gas flow to the pediatric pump-lung was initiated.…”

Assessment of Thrombelastography and Platelet Life Span in Ovines

“…The ovine is a frequently used preclinical animal model for the assessment of cardiovascular device function and biocompatibility . Adult ovines have hearts that are similar in size to the human heart for evaluation of implantable devices such as ventricular assist devices (VAD).…”

“…One of the primary endpoints of preclinical testing of blood contacting cardiovascular devices is to ensure adequate blood biocompatibility . Previously, flow cytometric assays to quantify activated ovine platelets have been reported and shown to be sensitive to blood pump complications and when there was subsequent evidence of thromboembolism .…”

Artificial Lungs: Current Status and Future Directions

“…The PediPL utilizes a similar HFM bundle and pump design as the APL and has also shown positive preclinical performance out to 30 days [11]. In an ovine model of acute respiratory failure, the PediPL demonstrated the ability to successfully treat both hypoxia and hypercapnia [12].…”