Fabrication, Characterization, and Hemocompatibility Investigation of Polysulfone Grafted With Polyethylene Glycol and Heparin Used in Membrane Oxygenators

Polyethyleneimine-assisted co-deposition of polydopamine coating with enhanced stability and efficient secondary modification

The stability and grafting efficiency are important for polydopamine (pDA) coatings used as platforms for secondary grafting.

Investigations of the characteristics and performance of modified polyethersulfones (PES) as membrane oxygenator

The modification of membrane oxygenators to minimize protein adsorption onto the surface is often accompanied by the loss of membrane performance. This study aims to explore polyethersulfone (PES) as a new material for membrane oxygenator applications and to assess its potentials. Accordingly, different modification techniques are applied to improve surface properties of PES membranes. To achieve this goal, two separate modification methods including incorporation of TiO2 into the membrane matrix as well as grafting polyethylene glycol (PEG) through oxygen plasma treatment are developed and the effects are examined. The results reveal that protein adsorption to the nanocomposite membrane containing 0.50 wt. % TiO2 and the grafted membrane decreased by 47 and 31%, respectively. In terms of performance, permeability and oxygen transfer rate of all modified membranes exceeded 808 GPU and 2.7 × 10−4 mol·m−2·s−1, respectively. Contact angle analysis revealed signs of hydrophilicity enhancement of membranes after modifications. The findings suggest that upon proper modifications, membranes based on PES could be considered as promising candidates for membrane oxygenator applications and deserves further investigations.

Recent advances in heparinization of polymeric membranes for enhanced continuous blood purification

Continuous blood purification technology such as hemodiafiltration has been used worldwide for saving patients suffering from severe diseases or organ function failure, especially in the intensive care unit and emergency setting. The filters as core devices are commonly made of polymer materials as hollow fiber membranes. However, the membrane is often inductively blocked by blood clot formation due to its interactions with blood components. Heparin is the anticoagulant often used in clinical practice for anti-coagulation. Recently, heparin is also employed to modify the hollow fiber membranes either chemically or physically to improve the filtration performance. This review summarizes recent advances in methodology for surface heparinization of such hollow fiber membranes, and their filtration performance improvement. The review also provides expert opinions for further research in this rapidly expanding field.

Extracorporeal carbon dioxide removal requirements for ultraprotective mechanical ventilation: Mathematical model predictions

Extracorporeal carbon dioxide (CO₂) removal (ECCO₂R) facilitates the use of low tidal volumes during protective or ultraprotective mechanical ventilation when managing patients with acute respiratory distress syndrome (ARDS); however, the rate of ECCO₂R required to avoid hypercapnia remains unclear. We calculated ECCO₂R rate requirements to maintain arterial partial pressure of CO₂ (PaCO₂) at clinically desirable levels in mechanically ventilated ARDS patients using a six‐compartment mathematical model of CO₂ and oxygen (O₂) biochemistry and whole‐body transport with the inclusion of an ECCO₂R device for extracorporeal veno‐venous removal of CO₂. The model assumes steady state conditions. Model compartments were lung capillary blood, arterial blood, venous blood, post‐ECCO₂R venous blood, interstitial fluid and tissue cells, with CO₂ and O₂ distribution within each compartment; biochemistry included equilibrium among bicarbonate and non‐bicarbonate buffers and CO₂ and O₂ binding to hemoglobin to elucidate Bohr and Haldane effects. O₂ consumption and CO₂ production rates were assumed proportional to predicted body weight (PBW) and adjusted to achieve reported arterial partial pressure of O₂ and a PaCO₂ level of 46 mmHg at a tidal volume of 7.6 mL/kg PBW in the absence of an ECCO₂R device based on average data from LUNG SAFE. Model calculations showed that ECCO₂R rates required to achieve mild permissive hypercapnia (PaCO₂ of 46 mmHg) at a ventilation frequency or respiratory rate of 20.8/min during mechanical ventilation increased when tidal volumes decreased from 7.6 to 3 mL/kg PBW. Higher ECCO2R rates were required to achieve normocapnia (PaCO2 of 40 mmHg). Model calculations also showed that required ECCO2R rates were lower when ventilation frequencies were increased from 20.8/min to 26/min. The current mathematical model predicts that ECCO2R rates resulting in clinically desirable PaCO2 levels at tidal volumes of 5‐6 mL/kg PBW can likely be achieved in mechanically ventilated ARDS patients with current technologies; use of ultraprotective tidal volumes (3‐4 mL/kg PBW) may be challenging unless high mechanical ventilation frequencies are used.

Artificial Organs 2016: A Year in Review

In this Editor's Review, articles published in 2016 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 Mechanical Circulatory Support, 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 were pleased to publish our second Virtual Issue in April 2016 on "Tissue Engineering in Bone" by Professor Tsuyoshi Takato. Our first was published in 2011 titled "Intra-Aortic Balloon Pumping" by Dr. Ashraf Khir. Other peer-reviewed Special Issues this year included contributions from the 11th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Ündar and selections from the 23rd Congress of the International Society for Rotary Blood Pumps edited by Dr. Bojan Biocina. 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 meaningful suggestions to the author's work whether eventually accepted or rejected. 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, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.

Superhemophobic titania nanotube array surfaces for blood contacting medical devices

Appropriate hemocompatible response for blood-contacting medical devices is necessary to prevent device failure.