Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Distress Syndrome: Possible Late Indication for Coronavirus Disease 2019?

Immobilization of carbonic anhydrase on modified PES membranes for artificial lungs

The introduction of carbonic anhydrase (CA) onto an extracorporeal membrane oxygenation (ECMO) membrane can improve the permeability of carbon dioxide (CO2). However, existing CA-grafting methods have limitations, and the hemocompatibility of current substrate membranes of commercial ECMO is not satisfactory. In this study, a 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC)/N-hydroxy succinimide (NHS) activation method is adopted to graft CA with CO2-catalyzed conversion activity onto a polyethersulfone (PES) membrane, which is prepared by a phase inversion technique after in situ crosslinking polymerization of 1-vinyl-2-pyrrolidone (VP) and acrylic acid (AA) in PES solution. The characterization results reveal that CA has been grafted onto the modified PES membrane successfully and exhibits catalytic activity. The kinetic parameters of esterase activity verify that the grafted amount of active CA increases with an increase in the concentration of the CA incubation solution. The CA-grafted membrane (CA-M) can accelerate the conversion of bicarbonate to CO2 in water and blood, which demonstrates the special catalytic activity towards bicarbonate of CA. Finally, blood compatibility tests prove that the CA-M does not lead to hemolysis, shows suppressed protein adsorption and increased coagulation time, and is suitable for application in ECMO. This work demonstrates a green and efficient method for preparing bioactive materials and has practical guiding significance for subsequent pulmonary membrane research and ECMO applications.