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Wang Y, Liu Y, Han Q, Lin H, Liu F. A novel poly (4-methyl-1-pentene)/polypropylene (PMP/PP) thin film composite (TFC) artificial lung membrane for enhanced gas transport and excellent hemo-compatibility. J Memb Sci 2022; 649:120359. [PMID: 36570331 PMCID: PMC9758018 DOI: 10.1016/j.memsci.2022.120359] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 12/27/2022]
Abstract
Extracorporeal membrane oxygenation is a technique that provides short-term supports to the heart and lungs. It removes CO2 from the blood and provides enough oxygen, which is a huge help in the fight against COVID-19. As the key component, the artificial lung membranes have evolved in three generations including silicon, polypropylene and poly (4-methyl-1-pentene). Herein, we for the first time design and fabricate a novel poly (4-methyl-1-pentene)/polypropylene (PMP/PP) thin film composite (TFC) membrane with the anticoagulant coating composed of poly (sodium 4-styrenesulfonate) and cross-linked poly (vinyl alcohol). Poly (sodium 4-styrenesulfonate) provides sulfonic acid groups to inhibit the coagulant factors (FVIII and FXII), and cross-linked poly (vinyl alcohol) increase the stability of the anticoagulant coating and further improve the hydrophilicity via abundant hydroxyl groups to depress the protein adsorption. Long-term anticoagulant property was demonstrated by whole human blood for 28 days. Blood compatibility was evaluated by hemolysis rate, anticoagulation activity (APTT, TT and PT), complement activation, platelet activation and contact activation. Pure CO2, O2 and N2 permeation rates were determined to evaluate the mass transfer properties of PMP/PP TFC membranes. Gas permeation results revealed that gas permeation flux increased in the TFC membranes because of the decrease of crystallinity. Overall, the so prepared PMP/PP membrane shows good CO2/O2 selectivity and blood compatibility as novel TFC artificial lung membrane.
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Affiliation(s)
- Yiwen Wang
- Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
- University of Chinese Academy of Sciences, Beijing, China, 19 A Yuquan Rd, Shijingshan District, Beijing, 100049, China
- Key Laboratory of Bio-based Polymeric Materials Technology and Application of Zhejiang Province, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
| | - Yang Liu
- Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
- University of Chinese Academy of Sciences, Beijing, China, 19 A Yuquan Rd, Shijingshan District, Beijing, 100049, China
- Key Laboratory of Bio-based Polymeric Materials Technology and Application of Zhejiang Province, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
| | - Qiu Han
- Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
- Key Laboratory of Bio-based Polymeric Materials Technology and Application of Zhejiang Province, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
| | - Haibo Lin
- Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
- Key Laboratory of Bio-based Polymeric Materials Technology and Application of Zhejiang Province, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
| | - Fu Liu
- Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
- University of Chinese Academy of Sciences, Beijing, China, 19 A Yuquan Rd, Shijingshan District, Beijing, 100049, China
- Key Laboratory of Bio-based Polymeric Materials Technology and Application of Zhejiang Province, No. 1219 Zhongguan West Rd, Ningbo, 315201, China
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Swol J, Shigemura N, Ichiba S, Steinseifer U, Anraku M, Lorusso R. Artificial lungs--Where are we going with the lung replacement therapy? Artif Organs 2020; 44:1135-1149. [PMID: 33098217 DOI: 10.1111/aor.13801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Abstract
Lung transplantation may be a final destination therapy in lung failure, but limited donor organ availability creates a need for alternative management, including artificial lung technology. This invited review discusses ongoing developments and future research pathways for respiratory assist devices and tissue engineering to treat advanced and refractory lung disease. An overview is also given on the aftermath of the coronavirus disease 2019 pandemic and lessons learned as the world comes out of this situation. The first order of business in the future of lung support is solving the problems with existing mechanical devices. Interestingly, challenges identified during the early days of development persist today. These challenges include device-related infection, bleeding, thrombosis, cost, and patient quality of life. The main approaches of the future directions are to repair, restore, replace, or regenerate the lungs. Engineering improvements to hollow fiber membrane gas exchangers are enabling longer term wearable systems and can be used to bridge lung failure patients to transplantation. Progress in the development of microchannel-based devices has provided the concept of biomimetic devices that may even enable intracorporeal implantation. Tissue engineering and cell-based technologies have provided the concept of bioartificial lungs with properties similar to the native organ. Recent progress in artificial lung technologies includes continued advances in both engineering and biology. The final goal is to achieve a truly implantable and durable artificial lung that is applicable to destination therapy.
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Affiliation(s)
- Justyna Swol
- Department of Respiratory Medicine, Allergology and Sleep Medicine, Intensive Care Medicine, Paracelsus Medical University Nuremberg, General Hospital Nuremberg, Nuremberg, Germany
| | - Norihisa Shigemura
- Division of Cardiovascular Surgery, Temple University Health System Inc., Philadelphia, PA, USA
| | - Shingo Ichiba
- Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Bunkyo-ku, Japan
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Aachen, Germany
| | - Masaki Anraku
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Japan
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department - Heart & Vascular Centre, Maastricht University Medical Hospital, Maastricht, The Netherlands
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3
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Abstract
Recent studies show improved outcomes in ambulated lung failure patients. Ambulation still remains a challenge in these patients. This necessitates development of more compact and less cumbersome respiratory support specifically designed to be wearable. The Paracorporeal Ambulatory Assist Lung (PAAL) is being designed for providing ambulatory support in lung failure patients during bridge to transplant or recovery. We previously published in vitro and acute in vivo results of the PAAL. This study further evaluates the PAAL for 5 days. Five-day in vivo studies with the PAAL were conducted in 50-60 kg sheep after heparinization (activated clotting time range: 190-250 s) and cannulation with a 27 Fr. Avalon Elite dual-lumen cannula. The animals were able to move freely in a stanchion while device flow, resistance, and hemodynamics were recorded hourly. Oxygenation and hemolysis were measured daily. Platelet activation, blood chemistry, and comprehensive blood counts are reported for preoperatively, on POD 0, and POD 5. Three animals survived for 5 days. No study termination resulted from device failure. One animal was terminated on POD 0 and one animal was terminated at POD 3. The device was operated between 1.93 and 2.15 L/min. Blood left the device 100% oxygenated. Plasma-free hemoglobin ranged 10.8-14.5 mg/dl. CD62-P expression was under 10%. Minimal thrombus was seen in devices at explant. Chronic use of the PAAL in awake sheep is promising based on our study. There were no device-related complications over the study course. This study represents the next step in our pathway to eventual clinical translation.
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Evseev AK, Zhuravel SV, Alentiev AY, Goroncharovskaya IV, Petrikov SS. Membranes in Extracorporeal Blood Oxygenation Technology. MEMBRANES AND MEMBRANE TECHNOLOGIES 2019. [DOI: 10.1134/s2517751619040024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Millar JE, von Bahr V, Malfertheiner MV, Ki KK, Redd MA, Bartnikowski N, Suen JY, McAuley DF, Fraser JF. Administration of mesenchymal stem cells during ECMO results in a rapid decline in oxygenator performance. Thorax 2019; 74:194-196. [PMID: 29622695 DOI: 10.1136/thoraxjnl-2017-211439] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 11/03/2022]
Abstract
Mesenchymal stem cells (MSCs) have attracted attention as a potential therapy for Acute Respiratory Distress Syndrome (ARDS). At the same time, the use of extracorporeal membrane oxygenation (ECMO) has increased among patients with severe ARDS. To date, early clinical trials of MSCs in ARDS have excluded patients supported by ECMO. Here we provide evidence from an ex-vivo model of ECMO to suggest that the intravascular administration of MSCs during ECMO may adversely impact the function of a membrane oxygenator. The addition of clinical grade MSCs resulted in a reduction of flow through the circuit in comparison to controls (0.6 ±0.35 L min-1vs 4.12 ± 0.03 L min-1, at 240 minutes) and an increase in the transoygenator pressure gradient (101±9 mmHg vs 21±4 mmHg, at 240 minutes). Subsequent immunohistochemistry analysis demonstrated quantities of MSCs highly adherent to membrane oxygenator fibres. This study highlights the potential harm associated with MSC therapy during ECMO and suggests further areas of research required to advance the translation of cell therapy in this population.
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Affiliation(s)
| | - Viktor von Bahr
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
- Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maximillian V Malfertheiner
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
- Department of Internal Medicine II, Cardiology and Pneumology, University Medical Center Regensburg, Regensburg, Germany
| | - Katrina K Ki
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
| | - Meredith A Redd
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Nicole Bartnikowski
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
| | - Jacky Y Suen
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
| | - Danny Francis McAuley
- Queen's University Belfast, Wellcome-Wolfson Centre for Experimental Medicine, Belfast, UK
| | - John F Fraser
- Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia
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Malkin AD, Ye SH, Lee EJ, Yang X, Zhu Y, Gamble LJ, Federspiel WJ, Wagner WR. Development of zwitterionic sulfobetaine block copolymer conjugation strategies for reduced platelet deposition in respiratory assist devices. J Biomed Mater Res B Appl Biomater 2018; 106:2681-2692. [PMID: 29424964 PMCID: PMC6085169 DOI: 10.1002/jbm.b.34085] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/04/2018] [Accepted: 01/19/2018] [Indexed: 01/22/2023]
Abstract
Respiratory assist devices, that utilize ∼2 m2 of hollow fiber membranes (HFMs) to achieve desired gas transfer rates, have been limited in their adoption due to such blood biocompatibility limitations. This study reports two techniques for the functionalization and subsequent conjugation of zwitterionic sulfobetaine (SB) block copolymers to polymethylpentene (PMP) HFM surfaces with the intention of reducing thrombus formation in respiratory assist devices. Amine or hydroxyl functionalization of PMP HFMs (PMP-A or PMP-H) was accomplished using plasma-enhanced chemical vapor deposition. The generated functional groups were conjugated to low molecular weight SB block copolymers with N-hydroxysuccinimide ester or siloxane groups (SBNHS or SBNHSi) that were synthesized using reversible addition fragmentation chain transfer polymerization. The modified HFMs (PMP-A-SBNHS or PMP-H-SBNHSi) showed 80-95% reduction in platelet deposition from whole ovine blood, stability under the fluid shear of anticipated operating conditions, and uninhibited gas exchange performance relative to non-modified HFMs (PMP-C). Additionally, the functionalization and SBNHSi conjugation technique was shown to reduce platelet deposition on polycarbonate and poly(vinyl chloride), two other materials commonly found in extracorporeal circuits. The observed thromboresistance and stability of the SB modified surfaces, without degradation of HFM gas transfer performance, indicate that this approach is promising for longer term pre-clinical testing in respiratory assist devices and may ultimately allow for the reduction of anticoagulation levels in patients being supported for extended periods. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2681-2692, 2018.
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Affiliation(s)
- Alexander D. Malkin
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Sang-Ho Ye
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Evan J. Lee
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Xiguang Yang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Yang Zhu
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Lara J. Gamble
- Department of Bioengineering and NESAC/BIO, University of Washington, Seattle, Washington 98195, United States
| | - William J. Federspiel
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
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Abstract
Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) are the only viable treatment options for lung failure patients at the end-stage, including acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD). These treatments, however, are associated with high morbidity and mortality because of long wait times for lung transplant. Contemporary clinical literature has shown ambulation improves post-transplant outcomes in lung failure patients. Given this, we are developing the Pittsburgh Ambulatory Assist Lung (PAAL), a truly wearable artificial lung that allows for ambulation. In this study, we targeted 180 ml/min oxygenation and determined the form factor for a hollow fiber membrane (HFM) bundle for the PAAL. Based on a previously published mass transfer correlation, we modeled oxygenation efficiency as a function of fiber bundle diameter. Three benchmark fiber bundles were fabricated to validate the model through in vitro blood gas exchange at blood flow rates from 1 to 4 L/min according to ASTM standards. We used the model to determine a final design, which was characterized in vitro through a gas exchange as well as a hemolysis study at 3.5 L/min. The percent difference between model predictions and experiment for the benchmark bundles ranged from 3% to 17.5% at the flow rates tested. Using the model, we predicted a 1.75 in diameter bundle with 0.65 m surface area would produce 180 ml/min at 3.5 L/min blood flow rate. The oxygenation efficiency was 278 ml/min/m and the Normalized Index of Hemolysis (NIH) was less than 0.05 g/100 L. Future work involves integrating this bundle into the PAAL for which an experimental prototype is under development in our laboratory.
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Madhani SP, D'Aloiso BD, Frankowski B, Federspiel WJ. Darcy Permeability of Hollow Fiber Membrane Bundles Made from Membrana Polymethylpentene Fibers Used in Respiratory Assist Devices. ASAIO J 2017; 62:329-31. [PMID: 26809086 DOI: 10.1097/mat.0000000000000348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hollow fiber membranes (HFMs) are used in blood oxygenators for cardiopulmonary bypass or in next generation artificial lungs. Flow analyses of these devices is typically done using computational fluid dynamics (CFD) modeling HFM bundles as porous media, using a Darcy permeability coefficient estimated from the Blake-Kozeny (BK) equation to account for viscous drag from fibers. We recently published how well this approach can predict Darcy permeability for fiber bundles made from polypropylene HFMs, showing the prediction can be significantly improved using an experimentally derived correlation between the BK constant (A) and bundle porosity (ε). In this study, we assessed how well our correlation for A worked for predicting the Darcy permeability of fiber bundles made from Membrana polymethylpentene (PMP) HFMs, which are increasingly being used clinically. Swatches in the porosity range of 0.4 to 0.8 were assessed in which sheets of fiber were stacked in parallel, perpendicular, and angled configurations. Our previously published correlation predicted Darcy within ±8%. A new correlation based on current and past measured permeability was determined: A = 497ε - 103; using this correlation measured Darcy permeability was within ±6%. This correlation varied from 8% to -3.5% of our prior correlation over the tested porosity range.
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Affiliation(s)
- Shalv P Madhani
- From the *McGowan Institute for Regenerative Medicine, †Department of Bioengineering, ‡Department of Chemical and Petroleum Engineering, and §Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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9
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Taking Your ECMO With You: Continued Progress Toward an Ambulatory Goal. ASAIO J 2017; 63:521-522. [PMID: 28806183 DOI: 10.1097/mat.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Harter TS, Brauner CJ, Matthews PGD. A novel technique for the precise measurement of CO 2 production rate in small aquatic organisms as validated on aeshnid dragonfly nymphs. J Exp Biol 2017; 220:964-968. [PMID: 28082613 DOI: 10.1242/jeb.150235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/30/2016] [Indexed: 11/20/2022]
Abstract
The present study describes and validates a novel yet simple system for simultaneous in vivo measurements of rates of aquatic CO2 production (ṀCO2 ) and oxygen consumption (ṀO2 ), thus allowing the calculation of respiratory exchange ratios (RER). Diffusion of CO2 from the aquatic phase into a gas phase, across a hollow fibre membrane, enabled aquatic ṀCO2 measurements with a high-precision infrared gas CO2 analyser. ṀO2 was measured with a PO2 optode using a stop-flow approach. Injections of known amounts of CO2 into the apparatus yielded accurate and highly reproducible measurements of CO2 content (R2=0.997, P<0.001). The viability of in vivo measurements was demonstrated on aquatic dragonfly nymphs (Aeshnidae; wet mass 2.17 mg-1.46 g, n=15) and the apparatus produced precise ṀCO2 (R2=0.967, P<0.001) and ṀO2 (R2=0.957, P<0.001) measurements; average RER was 0.73±0.06. The described system is scalable, offering great potential for the study of a wide range of aquatic species, including fish.
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Affiliation(s)
- Till S Harter
- Department of Zoology, University of British Columbia, 6270 University Boulevard, Vancouver, BC, Canada V6T 1Z4
| | - Colin J Brauner
- Department of Zoology, University of British Columbia, 6270 University Boulevard, Vancouver, BC, Canada V6T 1Z4
| | - Philip G D Matthews
- Department of Zoology, University of British Columbia, 6270 University Boulevard, Vancouver, BC, Canada V6T 1Z4
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Madhani SP, Frankowski BJ, Burgreen GW, Antaki JF, Kormos R, D'Cunha J, Federspiel WJ. In vitro and in vivo evaluation of a novel integrated wearable artificial lung. J Heart Lung Transplant 2017; 36:806-811. [PMID: 28359655 DOI: 10.1016/j.healun.2017.02.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/19/2017] [Accepted: 02/24/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Conventional extracorporeal membrane oxygenation (ECMO) is cumbersome and is associated with high morbidity and mortality. We are currently developing the Pittsburgh Ambulatory Assist Lung (PAAL), which is designed to allow for ambulation of lung failure patients during bridge to transplant or recovery. In this study, we investigated the in vitro and acute in vivo performance of the PAAL. METHODS The PAAL features a 1.75-inch-diameter, cylindrical, hollow-fiber membrane (HFM) bundle of stacked sheets, with a surface area of 0.65 m2 integrated with a centrifugal pump. The PAAL was tested on the bench for hydrodynamic performance, gas exchange and hemolysis. It was then tested in 40- to 60-kg adult sheep (n = 4) for 6 hours. The animals were cannulated with an Avalon Elite 27Fr dual-lumen catheter (DLC) inserted through the right external jugular into the superior vena cava (SVC), right atrium (RA) and inferior vena cava (IVC). RESULTS The PAAL pumped >250 mm Hg at 3.5 liters/min at a rotation speed of 2,100 rpm. Oxygenation performance met the target of 180 ml/min at 3.5 liters/min of blood flow in vitro, resulting in a gas-exchange efficiency of 278 ml/min/m2. The normalized index of hemolysis (NIH) for the PAAL and cannula was 0.054 g per 100 liters (n = 2) at 3.5 liters/min, as compared with 0.020 g per 100 liters (n = 2) for controls (DLC cannula and a Centrimag pump). Plasma-free hemoglobin (pfHb) was <20 mg/dl for all animals. Blood left the device 100% oxygenated in vivo and oxygenation reached 181 ml/min at 3.8 liters/min. CONCLUSION The PAAL met in vitro and acute in vivo performance targets. Five-day chronic sheep studies are planned for the near future.
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Affiliation(s)
- Shalv P Madhani
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian J Frankowski
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Greg W Burgreen
- Computational Fluid Dynamics Group, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, Mississippi, USA
| | - Jim F Antaki
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Robert Kormos
- Department of Surgery, University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania, USA
| | - Jonathan D'Cunha
- Department of Surgery, University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania, USA
| | - William J Federspiel
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
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12
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Ye SH, Arazawa DT, Zhu Y, Shankarraman V, Malkin AD, Kimmel JD, Gamble LJ, Ishihara K, Federspiel WJ, Wagner WR. Hollow fiber membrane modification with functional zwitterionic macromolecules for improved thromboresistance in artificial lungs. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2015; 31:2463-71. [PMID: 25669307 PMCID: PMC4391648 DOI: 10.1021/la504907m] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Respiratory assist devices seek optimized performance in terms of gas transfer efficiency and thromboresistance to minimize device size and reduce complications associated with inadequate blood biocompatibility. The exchange of gas with blood occurs at the surface of the hollow fiber membranes (HFMs) used in these devices. In this study, three zwitterionic macromolecules were attached to HFM surfaces to putatively improve thromboresistance: (1) carboxyl-functionalized zwitterionic phosphorylcholine (PC) and (2) sulfobetaine (SB) macromolecules (mPC or mSB-COOH) prepared by a simple thiol-ene radical polymerization and (3) a low-molecular weight sulfobetaine (SB)-co-methacrylic acid (MA) block copolymer (SBMAb-COOH) prepared by reversible addition-fragmentation chain transfer (RAFT) polymerization. Each macromolecule type was covalently immobilized on an aminated commercial HFM (Celg-A) by a condensation reaction, and HFM surface composition changes were analyzed by X-ray photoelectron spectroscopy. Thrombotic deposition on the HFMs was investigated after contact with ovine blood in vitro. The removal of CO2 by the HFMs was also evaluated using a model respiratory assistance device. The HFMs conjugated with zwitterionic macromolecules (Celg-mPC, Celg-mSB, and Celg-SBMAb) showed expected increases in phosphorus or sulfur surface content. Celg-mPC and Celg-SBMAb experienced rates of platelet deposition significantly lower than those of unmodified (Celg-A, >95% reduction) and heparin-coated (>88% reduction) control HFMs. Smaller reductions were seen with Celg-mSB. The CO2 removal rate for Celg-SBMAb HFMs remained comparable to that of Celg-A. In contrast, the rate of removal of CO2 for heparin-coated HFMs was significantly reduced. The results demonstrate a promising approach to modifying HFMs using zwitterionic macromolecules for artificial lung devices with improved thromboresistance without degradation of gas transfer.
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Affiliation(s)
- Sang-Ho Ye
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - David T. Arazawa
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Yang Zhu
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Venkat Shankarraman
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Alexander D. Malkin
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
| | - Jeremy D. Kimmel
- ALung Technologies, Inc., Pittsburgh, Pennsylvania 15203, United States
| | - Lara J. Gamble
- Department of Bioengineering and NESAC/BIO, University of Washington, Seattle, Washington 98195, United States
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - William J. Federspiel
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- ALung Technologies, Inc., Pittsburgh, Pennsylvania 15203, United States
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
- Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, United States
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