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In-vitro evaluation of limitations and possibilities for the future use of intracorporeal gas exchangers placed in the upper lobe position

  • Original Article
  • Artificial Lung / ECMO
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Abstract

The lack of donor organs has led to the development of alternative “destination therapies”, such as a bio-artificial lung (BA) for end-stage lung disease. Ultimately aiming at a fully implantable BA, general capabilities and limitations of different oxygenators were tested based on the model of BA positioning at the right upper lobe. Three different-sized oxygenators (neonatal, paediatric, and adult) were tested in a mock circulation loop regarding oxygenation and decarboxylation capacities for three respiratory pathologies. Blood flows were imitated by a roller pump, and respiration was imitated by a mechanical ventilator with different FiO2 applications. Pressure drops across the oxygenators and the integrity of the gas-exchange hollow fibers were analyzed. The neonatal oxygenator proved to be insufficient regarding oxygenation and decarboxylation. Despite elevated pCO2 levels, the paediatric and adult oxygenators delivered comparable sufficient oxygen levels, but sufficient decarboxylation across the oxygenators was ensured only at flow rates of 0.5 L min. Only the adult oxygenator indicated no significant pressure drops. For all tested conditions, gas-exchange hollow fibers remained intact. This is the first study showing the general feasibility of delivering sufficient levels of gas exchange to an intracorporeal BA via patient’s breathing, without damaging gas-exchange hollow fiber membranes.

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Authors and Affiliations

  1. Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, 40292, USA

    Erin Schumer & Mark Slaughter

  2. Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

    Klaus Höffler, Christian Kuehn, Axel Haverich & Bettina Wiegmann

  3. German Centre for Lung Research (DZL), Hannover, Germany

    Christian Kuehn, Axel Haverich & Bettina Wiegmann

  4. REBIRTH-Cluster of Excellence, Hannover Medical School, Hannover, Germany

    Axel Haverich & Bettina Wiegmann

Authors
  1. Erin Schumer
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  2. Klaus Höffler
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  3. Christian Kuehn
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  4. Mark Slaughter
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  5. Axel Haverich
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  6. Bettina Wiegmann
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Corresponding author

Correspondence to Bettina Wiegmann.

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The authors have no conflict of interest.

Funding

This work was supported by a travelling award from the International Society of Heart and Lung Transplantation, by the Cluster of Excellence REBIRTH (Unit 4.1) and the German Center for Lung Research (DZL: 82DZL00201).

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Schumer, E., Höffler, K., Kuehn, C. et al. In-vitro evaluation of limitations and possibilities for the future use of intracorporeal gas exchangers placed in the upper lobe position. J Artif Organs 21, 68–75 (2018). https://doi.org/10.1007/s10047-017-0987-0

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  • DOI: https://doi.org/10.1007/s10047-017-0987-0

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