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Radu ER, Voicu SI, Thakur VK. Polymeric Membranes for Biomedical Applications. Polymers (Basel) 2023; 15:polym15030619. [PMID: 36771921 PMCID: PMC9919920 DOI: 10.3390/polym15030619] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Polymeric membranes are selective materials used in a wide range of applications that require separation processes, from water filtration and purification to industrial separations. Because of these materials' remarkable properties, namely, selectivity, membranes are also used in a wide range of biomedical applications that require separations. Considering the fact that most organs (apart from the heart and brain) have separation processes associated with the physiological function (kidneys, lungs, intestines, stomach, etc.), technological solutions have been developed to replace the function of these organs with the help of polymer membranes. This review presents the main biomedical applications of polymer membranes, such as hemodialysis (for chronic kidney disease), membrane-based artificial oxygenators (for artificial lung), artificial liver, artificial pancreas, and membranes for osseointegration and drug delivery systems based on membranes.
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Affiliation(s)
- Elena Ruxandra Radu
- Department of Analytical Chemistry and Environmental Engineering, University Politehnica of Bucharest, 011061 Bucharest, Romania
- Advanced Polymers Materials Group, University Politehnica of Bucharest, 011061 Bucharest, Romania
| | - Stefan Ioan Voicu
- Department of Analytical Chemistry and Environmental Engineering, University Politehnica of Bucharest, 011061 Bucharest, Romania
- Advanced Polymers Materials Group, University Politehnica of Bucharest, 011061 Bucharest, Romania
- Correspondence: (S.I.V.); (V.K.T.)
| | - Vijay Kumar Thakur
- Biorefining and Advanced Materials Research Center, Scotland’s Rural College (SRUC), Kings Buildings, Edinburgh EH9 3JG, UK
- School of Engineering, University of Petroleum & Energy Studies (UPES), Dehradun 248007, Uttarakhand, India
- Centre for Research & Development, Chandigarh University, Mohali 140413, Punjab, India
- Correspondence: (S.I.V.); (V.K.T.)
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2
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Sakurai H, Fujiwara T, Ohuchi K, Hijikata W, Inoue Y, Maruyama O, Tahara T, Yokota S, Tanaka Y, Takewa Y, Mizuno T, Arai H. Innovative experimental animal models for real-time comparison of antithrombogenicity between two oxygenators using dual extracorporeal circulation circuits and indocyanine green fluorescence imaging. Artif Organs 2023; 47:77-87. [PMID: 35957489 DOI: 10.1111/aor.14380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/08/2022] [Accepted: 08/02/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Antithrombogenicity of extracorporeal membrane oxygenation (ECMO) devices, particularly oxygenators, is a current problem, with numerous studies and developments underway. However, there has been limited progress in developing methods to accurately compare the antithrombogenicity of oxygenators. Animal experiments are commonly conducted to evaluate the antithrombogenicity of devices; however, it is challenging to maintain a steady experimental environment. We propose an innovative experimental animal model to evaluate different devices in a constant experimental environment in real-time. METHODS This model uses two venous-arterial ECMO circuits attached to one animal (one by jugular vein and carotid artery, one by femoral vein and artery) and real-time assessment of thrombus formation in the oxygenator by indocyanine green (ICG) fluorescence imaging. Comparison studies were conducted using three pigs: one to compare different oxygenators (MERA vs. CAPIOX) (Case 1), and two to compare antithrombotic properties of the oxygenator (QUADROX) when used under different hydrodynamic conditions (continuous flow vs. pulsatile flow) (Cases 2 and 3). RESULTS Thrombi, visualized using ICG imaging, appeared as black dots on a white background in each oxygenator. In Case 1, differences in the site of thrombus formation and rate of thrombus growth were observed in real-time in two oxygenators. In Case 2 and 3, the thrombus region was smaller in pulsatile than in continuous conditions. CONCLUSIONS We devised an innovative experimental animal model for comparison of antithrombogenicity in ECMO circuits. This model enabled simultaneous evaluation of two different ECMO circuits under the same biological conditions and reduced the number of sacrificed experimental animals.
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Affiliation(s)
- Hironobu Sakurai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Center for Experimental Animals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yusuke Inoue
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Asahikawa, Japan
| | - Osamu Maruyama
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Tomoki Tahara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachie Yokota
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yui Tanaka
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yoshiaki Takewa
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Asahikawa, Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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3
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Fiusco F, Broman LM, Prahl Wittberg L. Blood Pumps for Extracorporeal Membrane Oxygenation: Platelet Activation During Different Operating Conditions. ASAIO J 2022; 68:79-86. [PMID: 34074850 PMCID: PMC8700320 DOI: 10.1097/mat.0000000000001493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) is a therapy used in severe cardiopulmonary failure. Blood is pumped through an artificial circuit exposing it to nonphysiologic conditions, which promote platelet activation and coagulation. Centrifugal pumps used at lower flow rates than their design point may lose pump efficiency and increase the risk of hemolysis. In this study, thrombogenic properties of two ECMO pumps designed for adult and neonatal use were evaluated using simulations in different flow scenarios. Three scenarios, adult pump in adult mode (4 L/min), adult pump in baby mode (300 ml/min), and neonatal pump used in its design point (300 ml/min), were simulated using computational fluid dynamics. The flow was numerically seeded with platelets, whose activation state was computed considering the stress history that acted along their respective path lines. Statistical distributions of activation state and residence time were drawn. The results showed that using the adult pump in baby mode increased the fraction of platelets with higher activation state confirming that low-pump flow rate impacts thrombogenicity. The neonatal pump showed a backflow at the inlet, which carried platelets in a retrograde motion contributing to an increased thrombogenic potential compared with the adult mode scenario.
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Affiliation(s)
- Francesco Fiusco
- From the Department of Engineering Mechanics, KTH, Stockholm, Sweden
- FLOW & BioMEx Center, KTH, Stockholm, Sweden
| | - Lars Mikael Broman
- ECMO Centre Karolinska, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lisa Prahl Wittberg
- From the Department of Engineering Mechanics, KTH, Stockholm, Sweden
- FLOW & BioMEx Center, KTH, Stockholm, Sweden
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4
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Gao S, Wang W, Qi J, Liu G, Wang J, Yan S, Teng Y, Zhou C, Wang Q, Yan W, Zhang Q, Liu Y, Gao B, Ji B. Safety and Efficacy of a Novel Centrifugal Pump and Driving Devices of the OASSIST ECMO System: A Preclinical Evaluation in the Ovine Model. Front Med (Lausanne) 2021; 8:712205. [PMID: 34708051 PMCID: PMC8542924 DOI: 10.3389/fmed.2021.712205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) provides cardiopulmonary support for critically ill patients. Portable ECMO devices can be applied in both in-hospital and out-of-hospital emergency conditions. We evaluated the safety and biocompatibility of a novel centrifugal pump and ECMO device of the OASSIST ECMO System (Jiangsu STMed Technologies Co., Suzhou, China) in a 168-h ovine ECMO model. Methods: The portable OASSIST ECMO system consists of the control console, the pump drive, and the disposable centrifugal pump. Ten healthy sheep were used to evaluate the OASSIST ECMO system. Five were supported on veno-venous ECMO and five on veno-arterial ECMO, each for 168 h. The systemic anticoagulation was achieved by continuous heparin infusion to maintain the activated clotting time (ACT) between 220 and 250 s. The rotary speed was set at 3,200–3,500 rpm. The ECMO configurations and ACT were recorded every 6 hours (h). The free hemoglobin (fHb), complete blood count, and coagulation action test were monitored, at the 6th h and every 24 h after the initiation of the ECMO. The dissection of the pump head and oxygenator were conducted to explore thrombosis. Results: Ten sheep successfully completed the study duration without device-related accidents. The pumps ran stably, and the ECMO flow ranged from 1.6 ± 0.1 to 2.0 ± 0.11 L/min in the V-V group, and from 1.8 ± 0.1 to 2.4 ± 0.14 L/min in the V-A group. The anticoagulation was well-performed. The ACT was maintained at 239.78 ± 36.31 s, no major bleeding or thrombosis was observed during the ECMO run or in the autopsy. 3/5 in the V-A group and 4/5 in the V-V group developed small thrombus in the bearing pedestal. No obvious thrombus formed in the oxygenator was observed. The hemolytic blood damage was not significant. The average fHb was 0.17 ± 0.12 g/L. Considering hemodilution, the hemoglobin, white blood cell, and platelets didn't reduce during the ECMO runs. Conclusions: The OASSIST ECMO system shows satisfactory safety and biocompatibility for the 168-h preclinical evaluation in the ovine model. The OASSIST ECMO system is promising to be applied in clinical conditions in the future.
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Affiliation(s)
- Sizhe Gao
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Weining Wang
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China.,Jiangsu STMed Technology Co. Ltd., Suzhou, China
| | - Jiachen Qi
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Gang Liu
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jian Wang
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Shujie Yan
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuan Teng
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chun Zhou
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Qian Wang
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Weidong Yan
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Qiaoni Zhang
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Youjun Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Bin Gao
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Bingyang Ji
- Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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He T, He J, Wang Z, Cui Z. Modification strategies to improve the membrane hemocompatibility in extracorporeal membrane oxygenator (ECMO). ADVANCED COMPOSITES AND HYBRID MATERIALS 2021; 4:847-864. [PMID: 33969267 PMCID: PMC8091652 DOI: 10.1007/s42114-021-00244-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 03/16/2021] [Indexed: 05/26/2023]
Abstract
ABSTRACT Since extracorporeal membrane oxygenator (ECMO) has been utilized to save countless lives by providing continuous extracorporeal breathing and circulation to patients with severe cardiopulmonary failure. In particular, it has played an important role during the COVID-19 epidemic. One of the important composites of ECMO is membrane oxygenator, and the core composite of the membrane oxygenator is hollow fiber membrane, which is not only a place for blood oxygenation, but also is a barrier between the blood and gas side. However, the formation of blood clots in the oxygenator is a key problem in the using process. According to the study of the mechanism of thrombosis generation, it was found that improving the hemocompatibility is an efficient approach to reduce thrombus formation by modifying the surface of materials. In this review, the corresponding modification methods (surface property regulation, anticoagulant grafting, and bio-interface design) of hollow fiber membranes in ECMO are classified and discussed, and then, the research status and development prospects are summarized.
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Affiliation(s)
- Ting He
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Chemistry and Chemical Engineering, Nanjing Tech University, 210009 Nanjing, China
| | - Jinhui He
- National Engineering Research Center for Special Separation Membrane, Nanjing Tech University, 210009 Nanjing, China
| | - Zhaohui Wang
- Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing Tech University, 210009 Nanjing, China
| | - Zhaoliang Cui
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Chemistry and Chemical Engineering, Nanjing Tech University, 210009 Nanjing, China
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Seki H, Fujiwara T, Hijikata W, Murashige T, Tahara T, Yokota S, Ogata A, Ohuchi K, Mizuno T, Arai H. Evaluation of real-time thrombus detection method in a magnetically levitated centrifugal blood pump using a porcine left ventricular assist circulation model. Artif Organs 2021; 45:726-735. [PMID: 33432615 DOI: 10.1111/aor.13915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023]
Abstract
Pump thrombosis induces significant complications and requires timely detection. We proposed real-time monitoring of pump thrombus in a magnetically levitated centrifugal blood pump (mag-lev pump) without using additional sensors, by focusing on the changes in the displacement of the pump impeller. The phase difference between the current and displacement of the impeller increases with pump thrombus. This thrombus detection method was previously evaluated through simulated circuit experiments using porcine blood. Evaluation of real-time thrombus detection in a mag-lev blood pump was performed using a porcine left ventricular assist circulation model in this study. Acute animal experiments were performed five times using five Japanese domestic pigs. To create thrombogenic conditions, fibrinogen coating that induces thrombus formation in a short time was applied to the inner surfaces of the pump. An inflow and an outflow cannula were inserted into the apex of the left ventricle and the carotid artery, respectively, by a minimally invasive surgical procedure that allowed minimal bleeding and hypothermia. Pump flow was maintained at 1 L/min without anticoagulation. The vibrational frequency of the impeller (70 Hz) and its vibrational amplitude (30 μm) were kept constant. The thrombus was detected based on the fact that the phase difference between the impeller displacement and input current to the magnetic bearing increases when a thrombus is formed inside a pump. The experiment was terminated when the phase difference increased by over 1° from the lowest value or when the phase difference was at the lowest value 12 hours after commencing measurements. The phase difference increased by over 1° in three cases. The pump was stopped after 12 hours in two cases. Pump thrombi were found in the pump in three cases in which the phase difference increased by over 1°. No pump thrombus was found in the other two cases in which the phase difference did not increase. We succeeded in real-time thrombus monitoring of a mag-lev pump in acute animal experiments.
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Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Tomotaka Murashige
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan.,Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoki Tahara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachie Yokota
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Asato Ogata
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Hemocompatibility of new magnetically-levitated centrifugal pump technology compared to the CentriMag adult pump. Sci Rep 2020; 10:22055. [PMID: 33328596 PMCID: PMC7744571 DOI: 10.1038/s41598-020-78709-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/26/2020] [Indexed: 11/25/2022] Open
Abstract
The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We thus investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS devices as a driving component. We compared those results with the CentriMag adult (C-Mag) device under the same conditions according to ISO10993-4. Blood samples were analyzed via enzyme-linked-immunosorbent-assay (ELISA) for markers of coagulation, complement system, and the inflammatory response. The time-dependent activation of the coagulation system was measured by detecting thrombin-anti-thrombin complexes (TAT). The activation of the complement system was determined by increased SC5b-9 levels in both groups. A significant activation of neutrophils (PMN-elastase) was detected within the C-Mag group, but not in the MT-Mag group. However, the amount of PMN-elastase at 360 min did not differ significantly between groups. The activation of the complement and coagulation system was found to be significantly time-dependent in both devices. However, coagulation activation as determined by the TAT level was lower in the MT-Mag group than in the C-Mag group. This slight disparity could have been achieved by the optimized secondary flow paths and surface coating, which reduces the interaction of the surface with blood.
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8
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Seki H, Fujiwara T, Hijikata W, Murashige T, Maruyama T, Yokota S, Ogata A, Ouchi K, Mizuno T, Arai H. Verification of a thrombus induction method at the target point inside the blood pump using a fibrinogen coating for a thrombus detection study. Artif Organs 2020; 44:968-975. [DOI: 10.1111/aor.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Wataru Hijikata
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | | | - Takuro Maruyama
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | - Sachie Yokota
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Asato Ogata
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Katsuhiro Ouchi
- Department of Advanced Surgical Technology Research and Development Tokyo Medical and Dental University Tokyo Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
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9
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Matsuda H. Development of ventricular assist device and heart transplantation in Japan: How people worked. Artif Organs 2020; 44:544-560. [PMID: 32347568 DOI: 10.1111/aor.13699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/31/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hikaru Matsuda
- Professor Emeritus, Osaka University, Suita, Osaka, Japan
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10
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Flow-induced platelet activation in components of the extracorporeal membrane oxygenation circuit. Sci Rep 2018; 8:13985. [PMID: 30228350 PMCID: PMC6143512 DOI: 10.1038/s41598-018-32247-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/29/2018] [Indexed: 11/23/2022] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) is used for rescue in severe respiratory and/or circulatory failure. The patient’s blood is pumped over artificial surfaces in the ECMO circuit. A platelet activation model was applied to study the potential thrombogenicity of ECMO circuit components: the centrifugal blood pump, cannulae, and tubing connectors. Based on the accumulated effect of the scalar form of the stress acting on the platelet over time, the activation model enables assessment of platelet activation and pinpoints regions of elevated activation risk in a component. Numerical simulations of the flow in different components of the ECMO circuit was carried out where the activation level is a function of the impact of local stress and its history along the path that the platelets follow. The results showed that the pump carried the largest risk for platelet activation followed by the reinfusion cannula and lastly the connectors. Pump thrombogenicity was mainly due to long residence time and high shear-rate while the connector showed a high level of non-stationary shear-rate that in turn may contribute to the formation of aggregates through direct platelet activation or through high shear-rate modulation of the vWF multimers.
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11
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Fujiwara T, Sakota D, Ohuchi K, Endo S, Tahara T, Murashige T, Kosaka R, Oi K, Mizuno T, Maruyama O, Arai H. Optical Dynamic Analysis of Thrombus Inside a Centrifugal Blood Pump During Extracorporeal Mechanical Circulatory Support in a Porcine Model. Artif Organs 2017; 41:893-903. [DOI: 10.1111/aor.12862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/07/2016] [Accepted: 08/19/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Tatsuki Fujiwara
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Daisuke Sakota
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Katsuhiro Ohuchi
- Department of Advanced Surgical Technology Research and Development; Tokyo Medical and Dental University
| | - Shu Endo
- Center for Experimental Animals, Tokyo Medical and Dental University
| | - Tomoki Tahara
- Faculty of Medicine; Tokyo Medical and Dental University
| | - Tomotaka Murashige
- Graduate School of Science and Technology; Tokyo University of Science; Ibaraki Japan
| | - Ryo Kosaka
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Keiji Oi
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Osamu Maruyama
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Hirokuni Arai
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
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12
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Ratio of surface roughness to flow scale as additional parameter for shear-induced hemolysis. Int J Artif Organs 2016; 39:205-10. [PMID: 27229319 DOI: 10.5301/ijao.5000500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND In addition to the conventional knowledge that shear stress and its exposure time should have a large impact on hemolysis, it became obvious through Dr. Maruyama's study that surface roughness would be the additional factor for high shear-induced hemolysis. Concerning this new information, we hypothesized that the ratio of surface roughness to the flow scale should play a role as the additional factor for shear-induced hemolysis. The purpose of this study was to develop a constant shear generator as the method to provide a controlled shear flow field with the combination between the controlled surface roughness and the flow scale to the blood cells. Its preliminary application was to validate our hypothesis. METHODS We prototyped the constant shear stress generator with the cylindrical cone-cup structure made from the acrylic material. This chamber had 3 flow scales of 1.00, 1.25, and 1.5 mm according to the change of the inner stationary cone, at which the surface roughness was distributed into the several levels between 0.14 and 0.92 micrometers in arithmetic average roughness. Using this shear chamber, we examined what effect the flow scale and the surface roughness had on hemolysis. RESULTS Our experimental data showed the tendency of a positive correlation between the ratio of surface roughness to the flow scale and the induced hemolysis levels, validating our hypothesis. CONCLUSIONS The ratio of the surface roughness to the flow scale should be the additional parameter for shear-induced hemolysis.
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13
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Optical aggregometry of red blood cells associated with the blood-clotting reaction in extracorporeal circulation support. J Artif Organs 2016; 19:241-8. [DOI: 10.1007/s10047-016-0895-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 03/10/2016] [Indexed: 11/27/2022]
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14
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Biocompatibility Assessment of the CentriMag-Novalung Adult ECMO Circuit in a Model of Acute Pulmonary Hypertension. ASAIO J 2015; 60:429-35. [PMID: 24658516 DOI: 10.1097/mat.0000000000000079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) is rarely used in patients with severe pulmonary hypertension (PH) as a bridge to lung transplantation. In this study, we assess the blood biocompatibility of the integrated CentriMag-Novalung ECMO system (venoarterial) in an acute model of PH. Severe PH (≥2/3 systemic) was induced in eight sheep through progressive ligation of the main pulmonary artery. System performance, platelet activation, thromboelastography (TEG) parameters, fibrinogen, plasma-free hemoglobin, and total plasma protein were measured at initiation, 3, and 6 hr of support in the ECMO (N = 4) and sham (N = 4) groups. A stable ECMO flow (2.2 ± 0.1 L/min), low transmembrane pressure gradient, and steady blood O2 and CO2 levels were maintained. Platelet activation was low (<4%) in both the groups, whereas platelet responsiveness to agonist (platelet activating factor) was reduced in the sham group when compared with the ECMO group. There were no differences in the TEG parameters, fibrinogen concentration, plasma-free hemoglobin (<10 mg/dl), and plasma total protein between the two groups. The findings of low levels of platelet activation and plfHb suggest adequate blood biocompatibility of the integrated CentriMag-Novalung circuit use for short-term support in a model of PH.
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Schibilsky D, Lenglinger M, Avci-Adali M, Haller C, Walker T, Wendel HP, Schlensak C. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices. Artif Organs 2015; 39:723-8. [DOI: 10.1111/aor.12544] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- David Schibilsky
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Matthias Lenglinger
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Meltem Avci-Adali
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Christoph Haller
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Tobias Walker
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Hans Peter Wendel
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
| | - Christian Schlensak
- Department of Thoracic and Cardiovascular Surgery; University Medical Center Tuebingen; Tübingen Germany
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Abstract
In this Editor's Review, articles published in 2013 are organized by category and briefly summarized. We aim to provide a brief reflection of the currently available worldwide knowledge that is intended to advance and better human life while providing insight for continued application of technologies and methods of organ Replacement, Recovery, and Regeneration. As the official journal of The International Federation for Artificial Organs, The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, the International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation, Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level". Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide so meaningful suggestions to the author's work whether eventually accepted or rejected and especially to those whose native tongue is not English. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, Wiley Periodicals, for their expert attention and support in the production and marketing of Artificial Organs. We look forward to recording further advances in the coming years.
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Yang Q, Mi B. Nanomaterials for membrane fouling control: accomplishments and challenges. Adv Chronic Kidney Dis 2013; 20:536-55. [PMID: 24206605 DOI: 10.1053/j.ackd.2013.08.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 08/21/2013] [Indexed: 12/13/2022]
Abstract
We report a review of recent research efforts on incorporating nanomaterials-including metal/metal oxide nanoparticles, carbon-based nanomaterials, and polymeric nanomaterials-into/onto membranes to improve membrane antifouling properties in biomedical or potentially medical-related applications. In general, nanomaterials can be incorporated into/onto a membrane by blending them into membrane fabricating materials or by attaching them to membrane surfaces via physical or chemical approaches. Overall, the fascinating, multifaceted properties (eg, high hydrophilicity, superparamagnetic properties, antibacterial properties, amenable functionality, strong hydration capability) of nanomaterials provide numerous novel strategies and unprecedented opportunities to fully mitigate membrane fouling. However, there are still challenges in achieving a broader adoption of nanomaterials in the membrane processes used for biomedical applications. Most of these challenges arise from the concerns over their long-term antifouling performance, hemocompatibility, and toxicity toward humans. Therefore, rigorous investigation is still needed before the adoption of some of these nanomaterials in biomedical applications, especially for those nanomaterials proposed to be used in the human body or in contact with living tissue/body fluids for a long period of time. Nevertheless, it is reasonable to predict that the service lifetime of membrane-based biomedical devices and implants will be prolonged significantly with the adoption of appropriate fouling control strategies.
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