Newly Developed Pediatric Membrane Oxygenator that Suppresses Excessive Pressure Drop in Cardiopulmonary Bypass and Extracorporeal Membrane Oxygenation (ECMO)

Fukuda, Makoto; Tokumine, Asako; Noda, Kyohei; Sakai, Kiyotaka

doi:10.3390/membranes10110362

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…In particular, each membrane has completely different anisotropic pore structure on the inner and outer surfaces of the membrane. Extracorporeal membrane oxygenator, which is the outside blood flow type, is the mainstream of membrane oxygenator [ 22 , 23 , 24 , 25 , 26 , 27 ]. Therefore, it is necessary to appropriately design the pore structure on the outer surface of the membrane that comes into direct contact with blood and the pore structure on the inner surface of the membrane that comes into contact with gas.…”

Section: Resultsmentioning

confidence: 99%

Electron Microscopic Confirmation of Anisotropic Pore Characteristics for ECMO Membranes Theoretically Validating the Risk of SARS-CoV-2 Permeation

et al. 2021

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The objective of this study is to clarify the pore structure of ECMO membranes by using our approach and theoretically validate the risk of SARS-CoV-2 permeation. There has not been any direct evidence for SARS-CoV-2 leakage through the membrane in ECMO support for critically ill COVID-19 patients. The precise pore structure of recent membranes was elucidated by direct microscopic observation for the first time. The three types of membranes, polypropylene, polypropylene coated with thin silicone layer, and polymethylpentene (PMP), have unique pore structures, and the pore structures on the inner and outer surfaces of the membranes are completely different anisotropic structures. From these data, the partition coefficients and intramembrane diffusion coefficients of SARS-CoV-2 were quantified using the membrane transport model. Therefore, SARS-CoV-2 may permeate the membrane wall with the plasma filtration flow or wet lung. The risk of SARS-CoV-2 permeation is completely different due to each anisotropic pore structure. We theoretically demonstrate that SARS-CoV-2 is highly likely to permeate the membrane transporting from the patient’s blood to the gas side, and may diffuse from the gas side outlet port of ECMO leading to the extra-circulatory spread of the SARS-CoV-2 (ECMO infection). Development of a new generation of nanoscale membrane confirmation is proposed for next-generation extracorporeal membrane oxygenator and system with long-term durability is envisaged.

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Section: Resultsmentioning

confidence: 99%

Electron Microscopic Confirmation of Anisotropic Pore Characteristics for ECMO Membranes Theoretically Validating the Risk of SARS-CoV-2 Permeation

et al. 2021

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“…The durability impaired by the occurrence of water vapor permeation and plasma leakage is affected not only by the membrane structure but also by the flowing blood and gas. Therefore, it is also desirable to explain how the blood is flowing outside the hollow fiber and to analyze the relationship between the flowing blood and gas and the module design of Capiox ® [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…BIOCUBE ® (NIPRO Co., Ltd., Tokyo, Japan) is shown for comparison [ 19 ]. A module design and technical data were shown in our previous study [ 19 , 30 ] to examine the blood flowing outside the hollow fiber. These are the outside blood flow oxygenators in which blood perfuse the outside of the hollow fiber membrane.…”

Section: Methodsmentioning

confidence: 99%

Insights into Gradient and Anisotropic Pore Structures of Capiox® Gas Exchange Membranes for ECMO: Theoretically Verifying SARS-CoV-2 Permeability

et al. 2022

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When using the extracorporeal capillary membrane oxygenator (sample A) for ECMO treatments of COVID-19 severely ill patients, which is dominantly used in Japan and worldwide, there is a concern about the risk of SARS-CoV-2 scattering from the gas outlet port of the membrane oxygenator. Terumo has launched two types of membranes (sample A and sample B), both of which are produced by the microphase separation processes using polymethylpentene (PMP) and polypropylene (PP), respectively. However, the pore structures of these membranes and the SARS-CoV-2 permeability through the membrane wall have not been clarified. In this study, we analyzed the pore structures of these gas exchange membranes using our previous approach and verified the SARS-CoV-2 permeation through the membrane wall. Both have the unique gradient and anisotropic pore structure which gradually become denser from the inside to the outside of the membrane wall, and the inner and outer surfaces of the membrane have completely different pore structures. The pore structure of sample A is also completely different from the other membrane made by the melt-extruded stretch process. From this, the pore structure of the ECMO membrane is controlled by designing various membrane-forming processes using the appropriate materials. In sample A, water vapor permeates through the coating layer on the outer surface, but no pores that allow SARS-CoV-2 to penetrate are observed. Therefore, it is unlikely that SARS-CoV-2 permeates through the membrane wall and scatter from sample A, raising the possibility of secondary ECMO infection. These results provide new insights into the evolution of a next-generation ECMO membrane.

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“…By using oxygen admixture in the gas phase of an HFMO, venous blood captures oxygen and releases a part of its carbon dioxide content, converting to arterial blood 5,6 . Therefore, an oxygenator, as a synonym for an artificial lung, can substitute the role of natural lung, which is crucially important during various therapeutical procedures, for example, cardiopulmonary bypass (CPB) surgeries and extracorporeal membrane oxygenation (ECMO) 3,7–10 …”

Section: Introductionmentioning

confidence: 99%

“…5,6 Therefore, an oxygenator, as a synonym for an artificial lung, can substitute the role of natural lung, which is crucially important during various therapeutical procedures, for example, cardiopulmonary bypass (CPB) surgeries and extracorporeal membrane oxygenation (ECMO). 3,[7][8][9][10] Hemodynamic through an oxygenator module has significant influences on the performance characteristics of an HFMO. [11][12][13] Conventionally, the blood pressure drop is considered as one of those characteristics.…”

Section: Introductionmentioning

confidence: 99%

In silico simulation of the liquid phase pressure drop through cylindrical hollow‐fiber membrane oxygenators using a modified phenomenological model

Tabesh

Rafiei

Mottaghy

2021

Asia-Pacific J Chem Eng

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Low blood pressure drop is an important performance characteristic of a hollow‐fiber membrane oxygenator (HFMO). While the application of natural blood corresponds to complex handling procedures, the in vitro investigation of liquid pressure drop is mainly done using water or similar fluids (e.g., normal saline solution [NSS]). In this study, a comprehensive phenomenological model has been proposed to predict the liquid pressure drop through a cylindrical HFMO, considering viscous and inertial resistances in porous media, derived from literature. The results demonstrate that approaches based on Darcy–Weisbach phenomenological equation correlate the most with in vitro experimental investigations using NSS and native porcine blood, in both pediatric and adult commercially available cylindrical HFMOs. Remarkably, this study corroborates theoretically and experimentally that approaches based on Ergun semi‐empirical equation fail to predict the liquid pressure drop in cylindrical HFMOs. Moreover, it is shown that the presented phenomenological model is also applicable to cylindrical hollow‐fiber heat exchangers, and subsequently, its noticeable effect on total liquid pressure drop through cylindrical HFMOs is demonstrated. The results reveal that this component may contribute to almost half of total blood pressure drop, and therefore, it should be redesigned using other approaches than hollow fibers.

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Newly Developed Pediatric Membrane Oxygenator that Suppresses Excessive Pressure Drop in Cardiopulmonary Bypass and Extracorporeal Membrane Oxygenation (ECMO)

Cited by 9 publications

References 21 publications

Electron Microscopic Confirmation of Anisotropic Pore Characteristics for ECMO Membranes Theoretically Validating the Risk of SARS-CoV-2 Permeation

Electron Microscopic Confirmation of Anisotropic Pore Characteristics for ECMO Membranes Theoretically Validating the Risk of SARS-CoV-2 Permeation

Insights into Gradient and Anisotropic Pore Structures of Capiox® Gas Exchange Membranes for ECMO: Theoretically Verifying SARS-CoV-2 Permeability

In silico simulation of the liquid phase pressure drop through cylindrical hollow‐fiber membrane oxygenators using a modified phenomenological model

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