Preclinical Evaluation of a New ECCO2R Setup

Schwärzel, Leonie S.; Jungmann, Anna M.; Schmoll, Nicole; Caspari, Stefan; Seiler, Frederik; Muellenbach, Ralf Michael; Bewarder, Moritz; Dinh, Q. Thai; Bals, Robert; Lepper, Philipp M.; Omlor, Albert

doi:10.1097/mat.0000000000001638

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…Although the recirculation loops caused slight increases in oxygen transfer, they also added additional tubing and bends to the ECMO setup, which might increase the risk for coagulation and inflammatory pathways. However, recirculation loops have also been described as tools that reduce the risk of membrane clotting due to the higher blood velocity in the membrane lung [ 18 ]. All in all, those benefits and risks of recirculation loops need further investigation in future research.…”

Section: Discussionmentioning

confidence: 99%

A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation

et al. 2022

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Extracorporeal membrane oxygenation (ECMO) has become an important therapeutic approach in the COVID-19 pandemic. The development and research in this field strongly relies on animal models; however, efforts are being made to find alternatives. In this work, we present a new mock circuit for ECMO that allows measurements of the oxygen transfer rate of a membrane lung at full ECMO blood flow. The mock utilizes a large reservoir of heparinized porcine blood to measure the oxygen transfer rate of the membrane lung in a single passage. The oxygen transfer rate is calculated from blood flow, hemoglobin value, venous saturation, and post-membrane arterial oxygen pressure. Before the next measuring sequence, the blood is regenerated to a venous condition with a sweep gas of nitrogen and carbon dioxide. The presented mock was applied to investigate the effect of a recirculation loop on the oxygen transfer rate of an ECMO setup. The recirculation loop caused a significant increase in post-membrane arterial oxygen pressure (paO2). The effect was strongest for the highest recirculation flow. This was attributed to a smaller boundary layer on gas fibers due to the increased blood velocity. However, the increase in paO2 did not translate to significant increases in the oxygen transfer rate because of the minor significance of physically dissolved oxygen for gas transfer. In conclusion, our results regarding a new ECMO mock setup demonstrate that recirculation loops can improve ECMO performance, but not enough to be clinically relevant.

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Section: Discussionmentioning

confidence: 99%

A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation

et al. 2022

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“…An explanation for the better oxygenation performance of the serial arrangement can be deduced from the concept of the boundary layer [14][15][16][17][18]. The boundary layer is a stationary fluid layer on the outside of the gas fibers that oxygen molecules need to pass via diffusion.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit

Omlor,

Caspari,

Omlor

et al. 2023

Membranes

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Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy method for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients with such instances of refractory hypoxemia received a second membrane lung, either in series or in parallel, to overcome the hypoxemia. It remains unclear whether the parallel or serial connection is more effective. Therefore, we used an improved version of our full-flow ECMO mock circuit to test this. The measurements were performed under conditions in which the membrane lungs were unable to completely oxygenate the blood. As a result, only the photometric pre- and post-oxygenator saturations, blood flow and hemoglobin concentration were required for the calculation of oxygen transfer rates. The results showed that for a pre-oxygenator saturation of 45% and a total blood flow of 10 L/min, the serial connection of two identical 5 L rated oxygenators is 17% more effective in terms of oxygen transfer than the parallel connection. Although the idea of using a second membrane lung if refractory hypoxia occurs is intriguing from a physiological point of view, due to the invasiveness of the solution, further investigations are needed before this should be used in a wider clinical setting.

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Preclinical Evaluation of a New ECCO2R Setup

Cited by 2 publications

References 32 publications

A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation

A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation

Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit

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