Practical and Theoretical Considerations for ECMO System Development

Abstract

Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for the temporary substitution for the heart and/or lungs in patients with acute cardiac or pulmonary failure. Recently, the development of portable systems has allowed for implementation of therapy outside of the intensive care units. ECMO can even be initiated in out-of-hospital situations to allow for patient stabilization and subsequent transfer to an appropriate hospital. This chapter will focus on the authors' development of a perfusion system based on a new double chamber pump. This unique design will, in theory, allow for a more complete and effective circulatory support to allow for myocardial and pulmonary recovery. The evolution from bench-top to animal testing will be described. The theoretical issues-including the advantages and disadvantages of roller and centrifugal pump designs-will also be discussed.

Extracorporeal membrane oxygenation (ECMO) in COVID-19 patients: a pocket guide for radiologists

“…In patients with COVID-19-unrelated ARDS, extracorporeal membrane oxygenation (ECMO) can be resorted to as a rescue therapy, allowing for temporary replacement of lung and/or heart function with artificial analogs in cardiac or pulmonary failure refractory to conventional clinical treatment [ 13 ]. The evidence collected so far in the literature has yielded mixed results, but several studies [ 14 , 15 ] have reported a survival rate in patients with COVID-19-related ARDS treated with ECMO not lower compared to those with COVID-19-unrelated ARDS [ 16 , 17 ].…”

Introductory Chapter: ECMO - Growing Indications, Applications, and Understanding of a Complex Supportive Therapy

“…While patient selection is a critical aspect of ECMO therapy, determining the type of therapy to initiate and how is likewise paramount. In the previous text, some of the topics related to cannulation techniques [7] and pump/circuit design and development were addressed [8]. The chapter by Borrelli further elaborates on these technical aspects of pump/circuit design by outlining their 23-year experience with pump positioning and holder systems.…”