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v.v. ECMO hemoglobin

Hideshi Itoh, Shingo Ichiba, Yoshihito Ujike, Takuma Douguchi, Hideaki Obata, Syuji Inamori, Tatsuo Iwasaki, Shingo Kasahara, Shunji Sano, Akif Ündar
The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08 ± 0.86 kg were divided into pulsatile (N = 7) and nonpulsatile (N = 7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house...
January 2016: Artificial Organs
Venkat Shankarraman, Ergin Kocyildirim, Salim E Olia, Marina V Kameneva, Ryan J Dzadony, Timothy M Maul, Marc A Simon, Hunter C Champion, William R Wagner, Christian A Bermudez
Extracorporeal membrane oxygenation (ECMO) is rarely used in patients with severe pulmonary hypertension (PH) as a bridge to lung transplantation. In this study, we assess the blood biocompatibility of the integrated CentriMag-Novalung ECMO system (venoarterial) in an acute model of PH. Severe PH (≥2/3 systemic) was induced in eight sheep through progressive ligation of the main pulmonary artery. System performance, platelet activation, thromboelastography (TEG) parameters, fibrinogen, plasma-free hemoglobin, and total plasma protein were measured at initiation, 3, and 6 hr of support in the ECMO (N = 4) and sham (N = 4) groups...
July 2014: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Karla Lehle, Alois Philipp, Thomas Müller, Frank Schettler, Thomas Bein, Christof Schmid, Matthias Lubnow
Membrane oxygenator (MO) failure is a known hazard during venovenous extracorporeal membrane oxygenation (v-v ECMO) therapy. Knowledge about technical and performance details of different ECMO systems (Maquet, Rastatt, Germany; Medos, Stolberg, Germany; Sorin, Modena, Italy) licensed for adults with acute lung failure might improve their handling. This retrospective study comprises 186 adult patients (Regensburg ECMO Registry) treated with v-v ECMO. Flow dynamic data were used to analyze the performance of different blood pumps, cannula types, and MOs to maintain an adequate blood flow (1-5 L/min)...
May 2014: Artificial Organs
Ozlem Bilen, Laura Loftis, Jun Teruya
We aim to present the case of a 5-week-old girl with severe respiratory failure placed on veno-venous extracorporeal membrane oxygenation (ECMO) that was then switched to veno-arterial ECMO. She required up to 60 units/kg/hr of heparin to keep her heparin level within the target range at .3-.7 units/mL. During the ECMO course, substantial thrombus formation was observed within the venous site of the ECMO cannula, which led to two circuit changes on ECMO day 9 and day 20. On ECMO day 15, she was noticed to have purpuric lesions on her chest and her right hand with no obvious arterial or venous clot detected by Doppler ultrasound...
June 2011: Journal of Extra-corporeal Technology
Fabio Turri, Jurandir Itizo Yanagihara
A two-dimensional numeric simulator is developed to predict the nonlinear, convective-reactive, oxygen mass exchange in a cross-flow hollow fiber blood oxygenator. The numeric simulator also calculates the carbon dioxide mass exchange, as hemoglobin affinity to oxygen is affected by the local pH value, which depends mostly on the local carbon dioxide content in blood. Blood pH calculation inside the oxygenator is made by the simultaneous solution of an equation that takes into account the blood buffering capacity and the classical Henderson-Hasselbach equation...
June 2011: Artificial Organs
Ru Lin, Lin-hua Tan, Ze-wei Zhang, Mei-yue Sun, Li-zhong Du
OBJECTIVE: To summarize the experience of extracorporeal membrane oxygenation (ECMO) to rescue a neonate with severe low cardiac output syndrome following open heart surgery. METHODS: The patient was a male, 2 d, 2.8 kg, G3P2 full-term neonate with gestational age 40 weeks, born by Cesarean-section with Apgar score of 10 at 1 min. He was admitted due to severe dyspnea with oxygen desaturation and heart murmur on the second day after birth. Physical examination showed clear consciousness, cyanosis, dyspnea, RR 70 bpm and a grade II/6 heart murmur...
January 2008: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Tadashi Motomura, Tomohiro Maeda, Shiniji Kawahito, Takahiro Matsui, Seiji Ichikawa, Hiroshi Ishitoya, Masaki Kawamura, Toshiyuki Shinohara, Koshiro Sato, Yoichiro Kawaguchi, Deborah Taylor, Daniel Oestmann, Julie Glueck, Yukihiko Nosé
Silicone rubber hollow fiber membrane produces an ideal gas exchange for long-term ECMO due to nonporous characteristics. The extracapillary type silicone rubber ECMO oxygenator having an ultrathin hollow fiber membrane was developed for pediatric application. The test modules were compared to conventional silicone coil-type ECMO modules. In vitro experiments demonstrated a higher O2 and CO2 transfer rate, lower blood flow resistance, and less hemolysis than the conventional silicone coil-type modules. This oxygenator was combined with the Gyro C1E3 centrifugal pump, and three ex vivo experiments were conducted to simulate pediatric V-A ECMO condition...
November 2003: Artificial Organs
Hwan Sung Lee, Yang Rae Rho, Hyuk Soo Lee, Chang Mo Hwang, Seong Wook Choi, Jung Chan Lee, Hyuk Choi, Sang Su Ahn, Kyung Sun, Ho Sung Son, Kwang Je Baek, Yong Soon Won, Byoung Goo Min
Extracorporeal life support (ECLS) systems have been increasingly applied to groups of patients with cardiorespiratory failure, including pediatric and adult patients with respiratory failure. Current pulsatile ECLS systems use a single pulsatile blood pump that generates a high inlet pressure in the membrane oxygenator. To minimize this high inlet pressure, we have developed a new and improved ECLS system, twin pulse life support (T-PLS). To analyze the advantages of T-PLS, we have compared T-PLS with a single pulsatile ECLS system...
2003: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
S Joriot-Chekaf, V Pierrat, L Desnoulez, T Rakza, P Lequien, L Storme
AIM OF THE STUDY: To evaluate a policy of treatment with human recombinant erythropoietin (rhEPO) and to describe factors related to red blood cell transfusions (RBCTs) in treated neonates. STUDY: Prospective, observative study. PATIENTS AND METHODS: One-hundred and sixty-five neonates with gestational age (GA) < 30 weeks and/or birthweight < 1000g admitted between may 1998 and october 1999. Ninety were excluded (congenital malformations n = 6, deaths n = 16, referral to a general hospital before discharge n = 67, ECMO n = 1)...
June 2003: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Shinji Kawahito, Tomohiro Maeda, Tadashi Motomura, Tamaki Takano, Kenji Nonaka, Joerg Linneweber, Seiji Ichikawa, Hiroshi Ishitoya, Kazuhiro Hanazaki, Julie Glueck, Koshiro Sato, Yukihiko Nosé
Currently in United States, there are no clinically-applicable hollow fiber extracorporeal membrane oxygenation (ECMO) oxygenators available. Therefore, our laboratory is in the process of developing a silicone hollow fiber membrane oxygenator for long-term ECMO usage. This oxygenator incorporates an ultrathin silicone hollow fiber. At this time, a specially-modified blood flow distributor (one chamber distributor) is centered in the module to prevent blood stagnation. An ex vivo long-term durability test for ECMO was performed using a healthy miniature calf for 2 weeks...
August 2002: Journal of Medical Investigation: JMI
Shinji Kawahito, Shuji Haraguchi, Tomohiro Maeda, Tadashi Motomura, Tamaki Takano, Kenji Nonaka, Joerg Linneweber, Seiji Ichikawa, Masaki Kawamura, Hiroshi Ishitoya, Julie Glueck, Koshiro Sato, Yukihiko Nosé
Based on the results of many experimental models, a hollow fiber silicone membrane oxygenator applicable for long-term extracorporeal membrane oxygenation (ECMO) was developed. For further high performance and antithrombogenicity, this preclinical model was modified, and a new improved oxygenator was successfully developed. In addition to ECMO application, the superior biocompatibility of silicone must be advantageous for pediatric cardiopulmonary bypass (CPB). An ex vivo short-term durability test for pediatric CPB was performed using a healthy miniature calf for six hours...
February 2002: Annals of Thoracic and Cardiovascular Surgery
T H Pedersen, V Videm, J L Svennevig, H Karlsen, R W Ostbakk, O Jensen, T E Mollnes
BACKGROUND: We studied whether negative inlet pressure created by a centrifugal pump during extracorporeal membrane oxygenation damages blood. METHODS: Fresh, whole human blood and primer were circulated through a test circuit, applying an inlet pressure of 0, -50, or -100 mm Hg. Thereafter, hemolysis and kidney function were compared between 6 patients treated before and 14 patients treated after inclusion in our setup of extracorporeal membrane oxygenation with a servo inlet pressure regulator...
May 1997: Annals of Thoracic Surgery
J V McDonald, T P Green, R H Steinhorn
While the use of the centrifugal vortex ECMO pump as an alternative to a roller-occlusion pump offers distinct advantages, unacceptable hemolysis may occur during its use in newborn infants. The authors studied 87 consecutive neonatal patients with respiratory failure supported with venoarterial ECMO using a centrifugal vortex pump. Baseline mean plasma free hemoglobin level for all patients during the first 48 hours of bypass was 31.3 +/- 3.1 md/dl. In 51 patients, an abrupt rise in the plasma free hemoglobin occurred...
January 1997: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
T Shimono, Y Shomura, K Tahara, I Hioki, H Tenpaku, Y Maze, R Hirano, H Shimpo, Y Shionoya, A Yokoyama, T Morikan, I Yada
The authors developed a new membrane oxygenator that consists of microporous polypropylene hollow fibers coated with a 0.2 micron ultrathin silicone layer. Five venoarterial bypasses were conducted on mongrel dogs for 24 hr using these new oxygenators. The blood flow rate was maintained at 750 ml/min, and the V/Q ratio was maintained at 1:1. As a control, three venoarterial bypasses were conducted under the same conditions using an oxygenator with the same design but without the silicone coating. Eight to 16 hr after the initiation of bypass, severe plasma leakage occurred in all control experiments, so the bypasses were terminated...
September 1996: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
L E Freed, G V Vunjak-Novakovic, P A Drinker, R Langer
A bioreactor for blood detoxification was developed in which oscillation-induced secondary flows suspend particles of immobilized enzyme in a reactor operating at clinically useful flowrates. Torsional oscillation of the reactor about its axis created a pair of counterrotating toroidal vortices which were readily observed in flow-visualization studies. Oscillation frequencies were selected to provide spatially uniform particle dispersion, as assessed visually. As a model system, blood deheparinization by reactors containing heparinase immobilized to agarose particles was investigated...
1993: Annals of Biomedical Engineering
T Perreault, K Mullahoo, L Morneault, A Johnston, V Adolph
We present the first report of clinical experience with a 12 French double-lumen cannula in a newborn supported with venovenous extracorporeal membrane oxygenation. This cannula was used because the internal jugular vein could not accommodate a 14F double-lumen catheter. This newborn was on bypass for 94 h, and the highest plasma free hemoglobin noted at the end of that period was 56 mg/dl. The infant was successfully weaned from extracorporeal membrane oxygenation and discharged home at 35 days of age. We suggest that this 12F catheter may be beneficial and deserves further evaluation...
January 1994: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
D McCoy-Pardington, W J Judd, P Knafl, L V Abruzzo, K R Coombes, S H Butch, H A Oberman
An analysis of the transfusion records of 91 neonatal patients subjected to extracorporeal membrane oxygenation (ECMO) is reported. Mean daily blood usage was 250 mL of red cells (RBCs), 80 mL of fresh-frozen plasma, and 2 units of platelets. Average time on ECMO was 4.6 days. Group O or ABO type-specific RBCs and group AB or ABO type-specific plasma products and platelets were transfused. RBCs were not washed, and neither RBCs nor other components were tested for anticytomegalovirus (CMV) or irradiated. No cases of posttransfusion CMV infection or graft-versus-host disease were observed...
May 1990: Transfusion
V A Subramanian, R L Berger
A marked increase in the carbon monoxide level in the blood sufficient to interfere with oxygen binding of hemoglobin was observed in a 43-year-old man during the course of extracorporeal membrane oxygenator support for acute respiratory failure from viral pneumonitis. The increased carbon monoxide level in this man was temporally related to the transfusion of large amounts of old bank blood. The etiology of an increased level of carbon monoxide in the blood during extracorporeal circulation is discussed and solutions to this problem are suggested...
August 1976: Annals of Thoracic Surgery
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