Abstract
Artificial lung technology is advancing at a startling rate raising hopes that it would better serve the needs of those requiring respiratory support. Whether to assist the healing of an injured lung, support patients to lung transplantation, or to entirely replace native lung function, safe and effective artificial lungs are sought. After 200 years of bioengineering progress, artificial lungs are closer than ever before to meet this demand which has risen exponentially due to the COVID-19 crisis. In this review, the critical advances in the historical development of artificial lungs are detailed. The current state of affairs regarding extracorporeal membrane oxygenation, intravascular lung assists, pump-less extracorporeal lung assists, total artificial lungs, and microfluidic oxygenators are outlined.
Highlights
The lungs are a vital part of the human respiratory system
Air travel through the mouth and nose down to the trachea, which is divided into smaller passages called the bronchial tubes that go into each lung
The 19th-century realization that blood could be artificially oxygenated quickly gave way to a number of devices for perfusing single organs. These early oxygenators laid the groundwork for the heart-lung machines of the 1950s that allowed the first cardiopulmonary bypass surgeries
Summary
The lungs are a vital part of the human respiratory system. It is the organ where the gaseous exchange occurs to maintain the basal functioning of the body. The only long-term treatment for patients with end-stage lung disease is pulmonary transplantation, but transplant demands well exceeds donation rates (Figure 1A) [1]. Year-end active wait-list counts have been steadily increasing, (except for year 2016), indicating that donation and transplant rates have not been able to keep pace with the influx of new lung transplant candidates (Figure 1B). The 19th-century realization that blood could be artificially oxygenated quickly gave way to a number of devices for perfusing single organs. These early oxygenators laid the groundwork for the heart-lung machines of the 1950s that allowed the first cardiopulmonary bypass surgeries. After a review of the history, an update on the progress and future directions of each of these artificial lung techniques will be investigated
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