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Marcano A, Fatyeyeva K, Koun M, Dubuis P, Grimme M, Chappey C, Marais S. Enhanced water and oxygen barrier performance of flexible polyurethane membranes for biomedical application. J Biomed Mater Res A 2021; 110:105-121. [PMID: 34288381 DOI: 10.1002/jbm.a.37269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/05/2021] [Accepted: 06/25/2021] [Indexed: 01/13/2023]
Abstract
In order to improve water and oxygen barrier properties, the surface of two commercial medical grade polyurethane (PU) membranes (Chronoflex® AR-LT and Bionate® II) was modified by a spray deposited film of poly(ethylene-co-vinyl alcohol) (EVOH). The influence of the temperature, the deposited layer thickness and the EVOH ethylene group percentage (27%, 32%, and 44% for EVOH27, EVOH32, and EVOH44, respectively) on the barrier properties of the PU/EVOH multilayered membranes was investigated. The increase of the EVOH layer thickness leads to higher oxygen barrier properties (the highest barrier improvement factor of 412 was obtained). However, in case of the deposited layer thickness higher than 18 μm, microcracks appeared on the treated surface promote a significant loss of the barrier effect. Due to its higher crystallinity degree, EVOH27 provides a higher oxygen barrier effect compared to EVOH32 and EVOH44. On the contrary, an increase of the water barrier properties was observed with the increase of the percentage of ethylene groups. Moreover, the delamination of the EVOH layer was noted after water permeation, especially in case of EVOH44, which is the most hydrophobic layer. Nevertheless, significant decrease of the water and oxygen permeability of the modified PU membranes was achieved, thus showing the benefit of using the EVOH spray deposition for the biomedical application, which requires high performance material with flexible and barrier properties.
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Affiliation(s)
- Aracelys Marcano
- Normandie Université, UNIROUEN, INSA ROUEN, CNRS, Polymères Biopolymères Surfaces (PBS), Rouen, France.,CARMAT SA, Vélizy Villacoublay, France
| | - Kateryna Fatyeyeva
- Normandie Université, UNIROUEN, INSA ROUEN, CNRS, Polymères Biopolymères Surfaces (PBS), Rouen, France
| | | | | | | | - Corinne Chappey
- Normandie Université, UNIROUEN, INSA ROUEN, CNRS, Polymères Biopolymères Surfaces (PBS), Rouen, France
| | - Stéphane Marais
- Normandie Université, UNIROUEN, INSA ROUEN, CNRS, Polymères Biopolymères Surfaces (PBS), Rouen, France
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Influence of the ECMO circuit on the concentration of nutritional supplements. Sci Rep 2020; 10:19275. [PMID: 33159150 PMCID: PMC7648645 DOI: 10.1038/s41598-020-76299-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/19/2020] [Indexed: 11/17/2022] Open
Abstract
Circulating compounds such as drugs and nutritional components might adhere to the oxygenator fibers and tubing during ECMO support. This study evaluated the amount of nutritional supplements adsorbed to the ECMO circuit under controlled ex vivo conditions. Six identical ECMO circuits were primed with fresh human whole blood and maintained under physiological conditions at 36 °C for 24 h. A dose of nutritional supplement calculated for a 70 kg patient was added. 150 mL volume was drawn from the priming bag for control samples and kept under similar conditions. Blood samples were obtained at predetermined time points and analyzed for concentrations of vitamins, minerals, lipids, and proteins. Data were analyzed using mixed models with robust standard errors. No significant differences were found between the ECMO circuits and the controls for any of the measured variables: cobalamin, folate, vitamin A, glucose, minerals, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides or total proteins. There was an initial decrease and then an increase in the concentration of cobalamin and folate. Vitamin A concentrations decreased in both groups over time. There was a decrease in concentration of glucose and an increased concentration of lactate dehydrogenase over time in both groups. There were no significant alterations in the concentrations of nutritional supplements in an ex vivo ECMO circuit compared to control samples. The time span of this study was limited, thus, clinical studies over a longer period of time are needed.
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Marcano A, Fatyeyeva K, Koun M, Dubuis P, Grimme M, Marais S. Recent developments in the field of barrier and permeability properties of segmented polyurethane elastomers. REV CHEM ENG 2018. [DOI: 10.1515/revce-2017-0033] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Polyurethane (PU) elastomers represent an important class of segmented copolymers. Thanks to many available chemical compositions, a rather broad range of chemical, physical, and biocompatible properties of PU can be obtained. These polymers are often characterized by high tensile and tear strength, elongation, fatigue life, and wear resistance. However, their relatively high permeability towards gases and water as well as their biocompatibility still limits the PU’s practical application, especially for biomedical use, for example, in implants and medical devices. In this review, the barrier and permeability properties of segmented PUs related to their chemical structure and physical and chemical properties have been discussed, including the latest developments and different approaches to improve the PU barrier properties.
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Affiliation(s)
- Aracelys Marcano
- Normandie University, UNIROUEN, INSA ROUEN, CNRS, PBS , 76000 Rouen , France
- CARMAT SA, 36 Avenue de l’Europe, Immeuble l’Etendard , 78140 Vélizy Villacoublay , France
| | - Kateryna Fatyeyeva
- Normandie University, UNIROUEN, INSA ROUEN, CNRS, PBS , 76000 Rouen , France
| | - Malys Koun
- ALTEN, 221bis Bd. Jean Jaurès , 92100 Boulogne-Billancourt , France
| | - Pascal Dubuis
- INOPROD, 46 Rue de Sarlieve , 63800 Cournon D’Auvergne , France
| | - Marc Grimme
- CARMAT SA, 36 Avenue de l’Europe, Immeuble l’Etendard , 78140 Vélizy Villacoublay , France
| | - Stéphane Marais
- Normandie University, UNIROUEN, INSA ROUEN, CNRS, PBS , 76000 Rouen , France
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Lawson DS, Holt D. Insensible water loss from the Jostra Quadrox D oxygenator: an in vitro study. Perfusion 2016; 22:407-10. [DOI: 10.1177/0267659108091337] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Extracorporeal membrane oxygenation (ECMO) has been shown to improve outcomes in neonatal patients with respiratory and/or cardiac failure. Insensible water loss is defined as water loss via evaporation from the skin and respiration. Fluid and electrolyte balance are a primary concern and very challenging in the neonatal patient population. Hypernatremia can result from untreated insensible water loss, leading to possible cerebral complications. A new type of fiber used in the Jostra Quadrox D oxygenator has recently been approved for use in the United States of America. This oxygenator uses a polymethylpentene closed hollow-fiber technology and has been approved for six hours of continuous use by the Federal Drug Administration. The closed hollow-fiber technology may be advantageous for extended use due to the fact that it is a true membrane and plasma leakage will not occur across its surface. The Jostra Quadrox D is an adult-sized oxygenator with a surface area of 1.8 M2. The aim of this study is to discover what the insensible water loss will be from the Jostra Quadrox D when used at blood flows which would mimic those used for a neonatal ECMO patient. The median insensible water loss from the Quadrox D oxygenator at a gas flow rate of two liters per minute(LPM) was 4.0 ± 0.2 ml/hour, at five LPM was 9.8 ± 0.4 ml/hour and at 10 LPM was 20.6 ± 0.7 ml/hour. The daily evaporative water loss from the Jostra Quadrox D can be estimated to be 48.0 ± 2.1 ml for each LPM of sweep gas with a normal saline pump flow rate of 500 ml/min.
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Affiliation(s)
- DS Lawson
- Duke University Health System, Durham, NC
| | - D Holt
- University of Nebraska Medical Center, Omaha, NE
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Effects on membrane lung gas exchange of an intermittent high gas flow recruitment maneuver: preliminary data in veno-venous ECMO patients. J Artif Organs 2015; 18:213-9. [DOI: 10.1007/s10047-015-0831-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
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Gill MC, O’Shaughnessy K. Insensible water loss from the Hilite 2400LT oxygenator: an in vitro study. Perfusion 2012; 28:70-5. [DOI: 10.1177/0267659112464097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Neonatal extracorporeal membrane oxygenation (ECMO) patients are particularly vulnerable to the effects of uncompensated insensible water loss resulting in hypernatraemia. There exists a long-standing relationship between hypernatraemia and varying degrees of cerebral dysfunction. The aim of this study is to explore the degree to which free water loss occurs across a commonly used ECMO oxygenator, the polymethylpentene (PMP) membrane Hilite® 2400LT (Medos, Medizintechnik AG, Stolberg, Germany). The secondary aim is to assess to what extent the addition of heat and/or humidity ameliorates this water loss. Methods: An ECMO circuit consisting of a centrifugal pump and a Hilite® 2400LT oxygenator was primed with crystalloid and albumin. Each experimental trial was carried out in triplicate, with gas flow rates of 1, 3 and 4.8 L/min being investigated. Fluid loss was assessed at six time points over a 24-hour period. Results: Water loss increased significantly from 1 to 3 L/min gas flow (p=0.05) and from 3 to 4.8 L/min gas flow (p=0.025). The mean water loss differences between the differing gas flow trials per L/min gas flow were non-significant (72.4 ±3.9 ml/24hrs). The effect of heating the gas to 37°C did not significantly alter water loss, whereas heat and humidity reduced water loss significantly (p=0.009). Conclusions: Insensible water loss from a Hilite® 2400LT oxygenator is approximately 72 ml/day per L/min gas flow over 24 hrs. Heating and humidifying the gas reduces the fluid loss significantly to approximately 8 ml/L/min gas flow over 24 hrs (p=0.009).
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Affiliation(s)
- MC Gill
- Perfusion Department, Heart Centre for Children, Sydney, Australia
| | - K O’Shaughnessy
- Perfusion Department, Heart Centre for Children, Sydney, Australia
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Xie X, Eberhart A, Guidoin R, Marois Y, Douville Y, Zhang Z. Five Types of Polyurethane Vascular Grafts in Dogs: The Importance of Structural Design and Material Selection. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 21:1239-64. [DOI: 10.1163/092050609x12481751806295] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Xingyi Xie
- a Department of Polymeric Biomaterials and Artificial Organs, College of Polymer Science and Engineering, Sichuan University, Chengdu, P. R. China; Department of Surgery, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Andreas Eberhart
- b Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Robert Guidoin
- c Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Yves Marois
- d Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Yvan Douville
- e Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Ze Zhang
- f Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5;,
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Alexander PJ, Lawson DS, Cornell J, Craig DM, Cheifetz IM. Insensible water loss from the medtronic minimax oxygenator: an In Vitro study. ASAIO J 2006; 52:206-10. [PMID: 16557110 DOI: 10.1097/01.mat.0000202275.72712.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purposes of this study were to quantify the insensible water loss that occurs across the Medtronic Minimax oxygenator and to estimate the resultant rise in fluid sodium concentration.A Carmeda-coated extracorporeal membrane oxygenation circuit connected to a Medtronic Minimax Plus oxygenator was primed with normal saline and attached to a closed reservoir. The gas sweep was randomly assigned to one of three rates: 2, 5, or 10 LPM (liters per minute). Each sweep rate was run in triplicate. The sodium concentration of the circuit was assessed after 12 and 24 hours of each trial. At the end of each 24-hour run, the evaporative loss was calculated. The average insensible water losses were 6.9+/-0.4 ml/h, 16.6+/-1.5 ml/h, and 34.4+/-0.3 ml/h at gas sweep rates of 2, 5, and 10 LPM, respectively (p<0.0001). Daily evaporative water losses for the membrane can be estimated to be 82.7+/-2.2 ml for each 1 LPM of sweep gas flow for a normal saline pump flow of 300 ml/min. In a closed circuit, a faster sweep gas rate is associated with a more rapid rise in sodium concentration (p<0.0001).
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Affiliation(s)
- Plato J Alexander
- Pediatric Critical Care Medicine, Perfusion Services, and Cardiothoracic Surgery, Duke Children's Hospital, Durham, North Carolina 27710, USA
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Camacho T, Totapally BR, Hultquist K, Nelson G, Eawaz D, Sussmane JB, Wolfsdorf J. Insensible water loss during extracorporeal membrane oxygenation: an in vitro study. ASAIO J 2000; 46:620-4. [PMID: 11016519 DOI: 10.1097/00002480-200009000-00022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To measure insensible fluid loss from silicone membrane oxygenators during extracorporeal membrane oxygenation (ECMO), an in vitro system was used. A standard neonatal ECMO circuit (Avecor) was connected to a noncompliant reservoir, which was then primed with normal saline. The experiment was conducted by using two silicone oxygenators (Avecor 0.4 and 0.8 m2), three gas flow rates (0.5, 1.0, and 2.0 L/min) (sweep), and two fluid flow rates (200 and 400 ml/min). Two methods were used to measure the water loss. One method was to replace the water to the noncompliant circuit by using a calibrated burette, and the other method was to collect condensed water after cooling the postmembrane sweep gas to 0 degrees C. The influence of the amount of sweep, fluid flow rate, size of membrane, and inlet and outlet sweep gas temperatures on measured water loss was statistically determined. The amount of water loss correlated with sweep (r2 = 0.81; p<0.00001) but was not related to the fluid flow rate, membrane size, or inlet and outlet sweep gas temperature. The average daily fluid loss measured with replacement and collection methods for each liter of sweep per minute were 72.0+/-12.6 and 62.3+/-10.0 ml, respectively. This information may be applied to clinical practice to accurately manage fluid balance in the sick neonate on ECMO.
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Affiliation(s)
- T Camacho
- Division of Critical Care Medicine, Miami Children's Hospital, Florida 33155-3009, USA
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Yang M, Zhang Z, Hahn C, Laroche G, King MW, Guidoin R. Totally implantable artificial hearts and left ventricular assist devices: selecting impermeable polycarbonate urethane to manufacture ventricles. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2000; 48:13-23. [PMID: 10029144 DOI: 10.1002/(sici)1097-4636(1999)48:1<13::aid-jbm4>3.0.co;2-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the development of a new generation of totally implantable artificial hearts and left ventricular assist devices (VADs) for long-term use, the selection of an acceptable material for the fabrication of the ventricles probably represents one of the greatest challenges. Segmented polyether urethanes used to be the material of choice due to their superior flexural performance, acceptable blood compatibility, and ease of processing. However, because they are known to degrade and to be readily permeable to water, they cannot meet the rigorous requirements needed for a new generation of implantable artificial hearts and VADs. Therefore, the objective of the present study was to identify alternative polymeric materials that would be satisfactory for fabricating the ventricles, and in particular, to determine the water permeability through membranes made from four commercial polycarbonate urethanes (Carbothane PC3570A, Chronoflex AR, Corethane 80A, and Corethane 55D) in comparison to those made from two traditional polyether urethanes (Tecoflex EG80A and Tecothane TT-1074A). In addition to determining the rate of water transmission through the six membranes by exposing them to deionized water, saline, and albumin-Krebs solution under pressure and measuring the displacement of liquid by means of a recently developed capillary method, the inherent surface and chemical properties of the six membranes were characterized by SEM, contact angle measurements, FTIR, DSC, and GPC techniques. The results of the study demonstrated that the rate of water transmission through the four polycarbonate urethane membranes was significantly lower than through the two polyether urethanes. In fact the lowest values were recorded with the two Corethane membranes, and the harder type 55D polymer had a lower value (2.7 x 10(-7) g/s cm2) than the softer 80A version (3.3 x 10(-7) g/s cm2). This level of water vapor permeability, which appears to be controlled primarily by a Fickian diffusion mechanism, is between 2 and 4 times lower than that obtained with traditional polyether urethane membranes of equivalent thickness. The superior performance of the polycarbonate urethanes is likely due to the inherently lower chain mobility of the carbonate structure in the soft segment phase. In addition, the study shows that additional impermeability to water vapor can be achieved by selecting a polyurethane polymer with a high hard segment content, an aromatic rather than aliphatic diisocyanate comonomer, and a more hydrophobic surface. The use of a higher molecular weight polyurethane is not necessarily efficacious if the above requirements are not met. As expected by Raoult's Law, the study found that the use of physiological media instead of deionized water further decreases the rate of water vapor transmission. Because none of today's commercial polyurethanes are totally impervious to water vapor transmission, additional work is needed to develop permeable polymers or to apply additional treatments to existing candidates to achieve an acceptable impermeable ventricle material.
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Affiliation(s)
- M Yang
- Department of Surgery, Laval University and Quebec Biomaterials Institute Inc., Canada
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