V7

• The respiratory system is responsible for the gas exchange

  • O2 in, CO2 out

• In combination with the circulatory system

• Task: artificial lung (membrane oxygenator) : O2 enrichment in blood, CO2 removal, Heat exchange

• Process: Integration of gas-liquid-contactor and heat exchanger in one module

• Advantages: High spec. Interfacial area (minor priming volume)

• Status: State of the art

• Limited gas transfer

• Lack of portability

• Large priming volumes (large quantities of blood outside the body)

• Finite lifetime

• Limited biocompatibility

—> Huge opportunity to improve patient quality of life and clinical outcomes

• Priming volume: Amount of blood that is external to the body at any time that the system is at use.

• Reducing priming volumes has been shown to:

  • Reduce post-operative blood transfusions

  • Advance patient hemodynamic recovery

  • Increase hematocrit values during the procedure

• Extracorporeal carbon dioxide removal (ECCO2R) devices are specialized ECMO devices that predominantly focus on CO2 removal.

• In combination with mechanical ventilation: ->lower tidal volumes required

• Driven by patient‘s cardiac output ->Pumpless

• Arterio-venous circuit

• More cost effective compared to ECMO

• Porous hollow fiber membrane based systems suffer from plasma leakage limiting lifetime to several hours to several days

• Silicone membrane and PMP coated hollow fiber artificial lungs can be used from one to two weeks before replacement —> Limited biolompatibility leads to clot formation

• Synthetic materials trigger inflammatory responses foreign body reactions, fibrous encapsulatioon, and platelet activation

• Remember, fibers are need to be hydrophobic…

• Heparin-coated devices and circuits have resulted in

  • Reduced inflammatory response

  • Improved clinical outcome

  • Reduced oxygenator failure

  • Reduced anticoagulation protocol

Possible Solution: