Newly Developed Pediatric Membrane Oxygenator that Suppresses Excessive Pressure Drop in Cardiopulmonary Bypass and Extracorporeal Membrane Oxygenation (ECMO).

Makoto Fukuda,Kiyotaka Sakai,Asako Tokumine,Kyohei Noda

doi:10.3390/membranes10110362

Makoto Fukuda, Kiyotaka Sakai + Show 2 more

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https://doi.org/10.3390/membranes10110362

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Abstract

This article developes a pediatric membrane oxygenator that is compact, high performance, and highly safe. This novel experimental approach, which imaging the inside of a membrane oxygenator during fluid perfusion using high-power X-ray CT, identifies air and blood retention in the local part of a membrane oxygenator. The cause of excessive pressure drop in a membrane oxygenator, which has been the most serious dysfunction in cardiovascular surgery and extracorporeal membrane oxygenation (ECMO), is the local retention of blood and air inside the oxygenator. Our designed blood flow channel for a membrane oxygenator has a circular channel and minimizes the boundary between laminated parts. The pressure drop in the blood flow channel is reduced, and the maximum gas transfer rates are increased by using this pediatric membrane oxygenator, as compared with the conventional oxygenator. Furthermore, it would be possible to reduce the incidents, which have occurred clinically, due to excessive pressure drop in the blood flow channel of the membrane oxygenator. The membrane oxygenator is said to be the “last stronghold” for patients with COVID-19 receiving ECMO treatment. Accordingly, the specification of our prototype is promising for low weight and pediatric patients.

Highlights

Membrane oxygenator is the artificial organ used in cardiopulmonary bypass (CPB), such as coronary artery bypass surgery, valve replacement surgery, implantable artificial heart surgery
It is a serious incident that puts the patient’s life endanger. To reduce such incidents and accidents, it is necessary to detect the occurrence of excessive pressure drops across membrane oxygenator in advance, and the pressure drops and the blood flow channel pressures at the inlet and outlet of the membrane oxygenators
Due to excessive pressure drop in cardiovascular surgery and extracorporeal membrane oxygenation (ECMO), we propose the design concept of a membrane oxygenator that suppress such blood retention and excessive pressure drop

Summary

Introduction

Membrane oxygenator is the artificial organ (artificial lung) used in cardiopulmonary bypass (CPB), such as coronary artery bypass surgery, valve replacement surgery, implantable artificial heart surgery. Membranes 2020, 10, 362 systemic centrifugal pump despite adequate anticoagulation [4,5,6,7,8] In this case, it is necessary to perform an emergency oxygenator changeover that is originally used with another unused membrane oxygenator. It is a serious incident that puts the patient’s life endanger To reduce such incidents and accidents, it is necessary to detect the occurrence of excessive pressure drops across membrane oxygenator in advance, and the pressure drops and the blood flow channel pressures at the inlet and outlet of the membrane oxygenators (1st pressure, 2nd pressure) are recommended to be monitored [5,6,7,8]. The Working group of the Japanese Society of Cardiovascular Surgery in Japan found that the incidence of membrane oxygenator replacement, due to excessive pressure drop was 1/3578 (0.03%) in adults and 1/576 (0.17%) in children (2016), and reported that there were six times more incidents of membrane oxygenator replacement in children than those in adults [9,10]

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