Use of a low-resistance compliant thoracic artificial lung in the pulmonary artery to pulmonary artery configuration

Scipione, Christopher N.; Schewe, Rebecca E.; Koch, Kelly L.; Shaffer, Andrew; Iyengar, Amit; Cook, Keith E.

doi:10.1016/j.jtcvs.2013.01.020

Cited by 11 publications

(6 citation statements)

References 27 publications

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“…17–19 However, the baseline resistance in this study was 1 mmHg/(L/min). In previous studies, the device was positioned ideally, sitting flat on the animal.…”

Section: Discussionmentioning

confidence: 61%

“…18,19 Overall, the cTAL demonstrated its capability to be used for at least two weeks without anti-coagulant coatings, and likely longer with more sophisticated biomaterials approaches. The device maintained a low, constant resistance.…”

Section: Discussionmentioning

confidence: 99%

“…Left thoracotomy, instrumentation, graft attachment, and closure proceeded according to previous methods. 18,19 Blood inflow and outflow graft-conduits with a combined prime volume of 116 mL were fabricated by bonding vascular grafts (Maquet Getinge, Wayne, NJ, or Terumo Cardiovascular, Ann Arbor, MI) to PVC tubing using previous methods. 20 These were attached to the PA and LA for cTAL connection.…”

Section: Methodsmentioning

confidence: 99%

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Fourteen Day In Vivo Testing of a Compliant Thoracic Artificial Lung

et al. 2017

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The compliant Thoracic Artificial Lung (cTAL) has been studied in acute in vivo and in vitro experiments. The cTAL’s long term function and potential use as a bridge to lung transplantation are assessed presently. The cTAL without anti-coagulant coatings was attached to sheep (n=5) via the pulmonary artery and left atrium for 14 days. Systemic heparin anticoagulation was utilized. cTAL resistance, cTAL gas exchange, hematologic parameters, and organ function were recorded. Two sheep were euthanized for non-device related issues. The cTAL’s resistance averaged 1.04±0.05 mmHg/(L/min) with no statistically significant increases. The cTAL transferred 180±8 mL/min of oxygen with 3.18±0.05 L/min of blood flow. Except for transient surgical effects, organ function markers were largely unchanged. Necropsies revealed pulmonary edema and atelectasis, but no other derangements. Hemoglobin levels dropped with device attachment but remained steady at 9.0±0.1 g/dL thereafter. In a fourteen day experiment, the cTAL without anti-coagulant coatings exhibited minimal clot formation. Sheep physiology was largely unchanged, except for device attachment related hemodilution. This suggests that patients treated with the cTAL shouldn’t require multiple blood transfusions. Once tested with anti-coagulant coatings and plasma resistant gas exchange fiber, the cTAL could serve as a bridge to transplantation.

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“…17–19 However, the baseline resistance in this study was 1 mmHg/(L/min). In previous studies, the device was positioned ideally, sitting flat on the animal.…”

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Fourteen Day In Vivo Testing of a Compliant Thoracic Artificial Lung

et al. 2017

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“…43 Compliant ALs and circuits have been developed to achieve impedances even lower than the natural lung. [44][45][46] Circuit compliance will be an important consideration for the development and implementation of the Pediatric MLung; however, in this work, we have focused solely on the resistance aspect of the AL. Future work will done to incorporate the proper level of compliance to the circuit.…”

Section: Discussionmentioning

confidence: 99%

Low-Resistance, Concentric-Gated Pediatric Artificial Lung for End-Stage Lung Failure

et al. 2020

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Children with end-stage lung failure awaiting lung transplant would benefit from improvements in artificial lung technology allowing for wearable pulmonary support as a bridge-to-transplant therapy. In this work, we designed, fabricated, and tested the Pediatric MLung-a dual-inlet hollow fiber artificial lung based on concentric gating, which has a rated flow of 1 L/min, and a pressure drop of 25 mm Hg at rated flow. This device and future iterations of the current design are designed to relieve pulmonary arterial hypertension, provide pulmonary support, reduce ventilator-associated injury, and allow for more effective therapy of patients with end-stage lung disease, including bridge-to-transplant treatment. Keywords extracorporeal life support; hollow fiber oxygenator; wearable artificial lung One in five children with end-stage lung failure (ESLF) die while awaiting transplant. 1 Hollow fiber oxygenators or artificial lungs (ALs) are commonly used to provide pulmonary support in acute and bridge-to-transplant applications. In these devices, blood flows around a bundle of hollow fibers, while a sweep gas supplied to the fibers' lumens facilitates gas transfer via diffusion through the fiber wall. The benefits of a particular AL depend on the design properties and engineering of the AL, and device development must be thoughtfully targeted to the intended patient population to achieve optimal results. In this work, we design, fabricate, and test the performance of a paracorporeal, pumpless device intended for pediatric patients. This device, called the "Pediatric MLung," can be used as a bridge to transplant for children with ESLF.

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“…39 Compliant artificial lungs and circuits have been developed to achieve impedances even lower than the natural lung. 40–42 Circuit compliance will be an important consideration for the development and implementation of the Pediatric MLung, however in this work we have focused solely on the resistance aspect of the artificial lung. Future work will done to incorporate the proper level of compliance to the circuit.…”

Section: Discussionmentioning

confidence: 99%