Abstract

The recent emergence of microfluidic extracorporeal lung support technologies presents an opportunity to achieve high gas transfer efficiency and improved hemocompatibility relative to the current standard of care in extracorporeal membrane oxygenation (ECMO). However, a critical challenge in the field is the ability to scale these devices to clinically relevant blood flow rates, in part because the typically very low blood flow in a single layer of a microfluidic oxygenator device requires stacking of a logistically challenging number of layers. We have developed biomimetic microfluidic oxygenators for the past decade and report here on the development of a high-flow (30 mL/min) single-layer prototype, scalable to larger structures via stacking and assembly with blood distribution manifolds. Microfluidic oxygenators were designed with biomimetic in-layer blood distribution manifolds and arrays of parallel transfer channels, and were fabricated using high precision machined durable metal master molds and microreplication with silicone films, resulting in large area gas transfer devices. Oxygen transfer was evaluated by flowing 100% O2 at 100 mL/min and blood at 0–30 mL/min while monitoring increases in O2 partial pressures in the blood. This design resulted in an oxygen saturation increase from 65% to 95% at 20 mL/min and operation up to 30 mL/min in multiple devices, the highest value yet recorded in a single layer microfluidic device. In addition to evaluation of the device for blood oxygenation, a 6-h in vitro hemocompatibility test was conducted on devices (n = 5) at a 25 mL/min blood flow rate with heparinized swine donor blood against control circuits (n = 3). Initial hemocompatibility results indicate that this technology has the potential to benefit future applications in extracorporeal lung support technologies for acute lung injury.

Highlights

  • Introductionmechanical ventilation (MV) is associated with mechanical damage to already fragile lungs (barotrauma), risk of ventilatorassociated pneumonia or other infections due to microbial entry during the procedure, and a complex array of mechanisms of inflammatory and biochemically-induced damage to the lungs, termed biotrauma [5]

  • These factors, along with the challenges associated with the use of mechanical ventilation (MV) to effectively treat emerging pandemic infections such as COVID-19 [6,7], have dramatically increased the level of interest in Extracorporeal Membrane Oxygenation (ECMO) [8], during which blood is circulated through an external circuit where gas exchange takes place in an artificial lung, allowing ventilator support to be reduced or, in rare cases, avoided

  • With a suitably defined network design, flow and shear rates within it can be made uniform throughout [44]. This feature enables the reduction of coagulation-related events in the oxygenator and compelled us to explore the gas transfer performance and hemocompatibility of a microfluidic oxygenator design inspired by these principles

Read more

Summary

Introduction

MV is associated with mechanical damage to already fragile lungs (barotrauma), risk of ventilatorassociated pneumonia or other infections due to microbial entry during the procedure, and a complex array of mechanisms of inflammatory and biochemically-induced damage to the lungs, termed biotrauma [5] These factors, along with the challenges associated with the use of MV to effectively treat emerging pandemic infections such as COVID-19 [6,7], have dramatically increased the level of interest in Extracorporeal Membrane Oxygenation (ECMO) [8], during which blood is circulated through an external circuit where gas exchange takes place in an artificial lung, allowing ventilator support to be reduced or, in rare cases, avoided. Limitations in the efficiency of the gas transfer process, a requirement for fairly vigorous gas/blood mixing in extracorporeal carbon dioxide removal (ECCO2R) [16], and complications involving anticoagulation, heparin dosing, and thrombus formation, have all contributed toward efforts to look for safer and more efficacious advances in ECMO technology

Objectives
Methods
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call