Hemocompatibility of a Miniaturized Extracorporeal Membrane Oxygenation and a Pumpless Interventional Lung Assist in Experimental Lung Injury
Extracorporeal membrane oxygenation (ECMO) is used for most severe acute respiratory distress syndrome cases in specialized centers. Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arterio...
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| Veröffentlicht in: | Artificial organs 2010-01, Vol.34 (1), p.13-21 |
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| creator | Kopp, Ruedger Bensberg, Ralf Henzler, Dietrich Niewels, Anja Randerath, Simone Rossaint, Rolf Kuhlen, Ralf |
| description | Extracorporeal membrane oxygenation (ECMO) is used for most severe acute respiratory distress syndrome cases in specialized centers. Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arteriovenous perfusion of a low‐resistance oxygenator without a blood pump (Novalung, Hechingen, Germany) or a miniaturized ECMO with reduced filling volume and a diagonal blood pump (Deltastream, Medos AG, Stolberg, Germany) could optimize hemocompatibility. The aim of the study was to compare hemocompatibility with conventional ECMO. Female pigs were connected to extracorporeal circulation for 24 h after lavage induced lung injury (eight per group). Activation of coagulation and immune system as well as blood cell damage was measured. A P value |
| doi_str_mv | 10.1111/j.1525-1594.2009.00791.x |
| format | Article |
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Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arteriovenous perfusion of a low‐resistance oxygenator without a blood pump (Novalung, Hechingen, Germany) or a miniaturized ECMO with reduced filling volume and a diagonal blood pump (Deltastream, Medos AG, Stolberg, Germany) could optimize hemocompatibility. The aim of the study was to compare hemocompatibility with conventional ECMO. Female pigs were connected to extracorporeal circulation for 24 h after lavage induced lung injury (eight per group). Activation of coagulation and immune system as well as blood cell damage was measured. A P value <0.05 was considered significant. Plasmatic coagulation was slightly activated in all groups demonstrated by increased thrombin‐anti‐thrombin III‐complex. No clinical signs of bleeding or thromboembolism occurred. Thrombelastography revealed decreased clotting capacities after miniaturized ECMO, probably due to significantly reduced platelet count. These resulted in reduced dosage of intravenous heparin. Scanning electron microscopy of oxygenator fibers showed significantly increased binding and shape change of platelets after interventional lung assist. In all groups, hemolysis remained negligible, indicated by low plasma hemoglobin concentration. Interleukin 8 and tumor necrosis factor‐α concentration as well as leukocyte count remained unchanged. Both devices demonstrated adequate hemocompatibility for safe clinical application, although a missing blood pump did not increase hemocompatibility. Further studies seem necessary to analyze the influence of different blood pumps on platelet drop systematically.</description><identifier>ISSN: 0160-564X</identifier><identifier>EISSN: 1525-1594</identifier><identifier>DOI: 10.1111/j.1525-1594.2009.00791.x</identifier><identifier>PMID: 19821813</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Acute Lung Injury - therapy ; Adult respiratory distress syndrome ; Animals ; Blood coagulation ; Blood Coagulation Tests ; Blood Platelets - ultrastructure ; Coated Materials, Biocompatible ; Cytokines - secretion ; Extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - instrumentation ; Female ; Hemocompatibility testing ; Heparin ; Materials Testing ; Microscopy, Electron, Scanning ; Oxygenators ; Respiratory Distress Syndrome, Adult - therapy ; Swine</subject><ispartof>Artificial organs, 2010-01, Vol.34 (1), p.13-21</ispartof><rights>2009, Copyright the Authors. Journal compilation © 2009, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4371-13ee6b9ee85e166892a286c54907cf0de2d9ef9da2644921ce84fd926dd71303</citedby><cites>FETCH-LOGICAL-c4371-13ee6b9ee85e166892a286c54907cf0de2d9ef9da2644921ce84fd926dd71303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1525-1594.2009.00791.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1525-1594.2009.00791.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19821813$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kopp, Ruedger</creatorcontrib><creatorcontrib>Bensberg, Ralf</creatorcontrib><creatorcontrib>Henzler, Dietrich</creatorcontrib><creatorcontrib>Niewels, Anja</creatorcontrib><creatorcontrib>Randerath, Simone</creatorcontrib><creatorcontrib>Rossaint, Rolf</creatorcontrib><creatorcontrib>Kuhlen, Ralf</creatorcontrib><title>Hemocompatibility of a Miniaturized Extracorporeal Membrane Oxygenation and a Pumpless Interventional Lung Assist in Experimental Lung Injury</title><title>Artificial organs</title><addtitle>Artif Organs</addtitle><description>Extracorporeal membrane oxygenation (ECMO) is used for most severe acute respiratory distress syndrome cases in specialized centers. Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arteriovenous perfusion of a low‐resistance oxygenator without a blood pump (Novalung, Hechingen, Germany) or a miniaturized ECMO with reduced filling volume and a diagonal blood pump (Deltastream, Medos AG, Stolberg, Germany) could optimize hemocompatibility. The aim of the study was to compare hemocompatibility with conventional ECMO. Female pigs were connected to extracorporeal circulation for 24 h after lavage induced lung injury (eight per group). Activation of coagulation and immune system as well as blood cell damage was measured. A P value <0.05 was considered significant. Plasmatic coagulation was slightly activated in all groups demonstrated by increased thrombin‐anti‐thrombin III‐complex. No clinical signs of bleeding or thromboembolism occurred. Thrombelastography revealed decreased clotting capacities after miniaturized ECMO, probably due to significantly reduced platelet count. These resulted in reduced dosage of intravenous heparin. Scanning electron microscopy of oxygenator fibers showed significantly increased binding and shape change of platelets after interventional lung assist. In all groups, hemolysis remained negligible, indicated by low plasma hemoglobin concentration. Interleukin 8 and tumor necrosis factor‐α concentration as well as leukocyte count remained unchanged. Both devices demonstrated adequate hemocompatibility for safe clinical application, although a missing blood pump did not increase hemocompatibility. Further studies seem necessary to analyze the influence of different blood pumps on platelet drop systematically.</description><subject>Acute Lung Injury - therapy</subject><subject>Adult respiratory distress syndrome</subject><subject>Animals</subject><subject>Blood coagulation</subject><subject>Blood Coagulation Tests</subject><subject>Blood Platelets - ultrastructure</subject><subject>Coated Materials, Biocompatible</subject><subject>Cytokines - secretion</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - instrumentation</subject><subject>Female</subject><subject>Hemocompatibility testing</subject><subject>Heparin</subject><subject>Materials Testing</subject><subject>Microscopy, Electron, Scanning</subject><subject>Oxygenators</subject><subject>Respiratory Distress Syndrome, Adult - therapy</subject><subject>Swine</subject><issn>0160-564X</issn><issn>1525-1594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhS0EotPCKyDvWCX4J3Fiic1oVNqRZjpQVSpiY3mSm8pD4gQ7gaTvwDvjMENZgje2dM53rq4PQpiSmIbz7hDTlKURTWUSM0JkTEgmaTw-Q4sn4TlaECpIlIrk8xk69_5Agish4iU6ozJnNKd8gX5eQ9MWbdPp3uxNbfoJtxXWeGus0f3gzCOU-HLsnS5a17UOdI230OydtoB34_QANpCtxdqWAfs4NF0N3uO17cF9BztrAdkM9gEvvTe-x8aGwA6caYL8R1vbw-CmV-hFpWsPr0_3Bbr7cHm3uo42u6v1armJioRnNKIcQOwlQJ4CFSKXTLNcFGkiSVZUpARWSqhkqZlIEsloAXlSlZKJsswoJ_wCvT3Gdq79NoDvVWN8AXUdlmoHr7JEsIxTJv_t5FxSTnMenPnRWbjWeweV6sKG2k2KEjWXpg5q7kbN3ai5NPW7NDUG9M1pyLBvoPwLnloKhvdHww9Tw_TfwWq5uw2PgEdHPPw-jE-4dl-VyHiWqvubK7UlN9vVp_tb9YX_AhMLt5g</recordid><startdate>201001</startdate><enddate>201001</enddate><creator>Kopp, Ruedger</creator><creator>Bensberg, Ralf</creator><creator>Henzler, Dietrich</creator><creator>Niewels, Anja</creator><creator>Randerath, Simone</creator><creator>Rossaint, Rolf</creator><creator>Kuhlen, Ralf</creator><general>Blackwell Publishing Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>201001</creationdate><title>Hemocompatibility of a Miniaturized Extracorporeal Membrane Oxygenation and a Pumpless Interventional Lung Assist in Experimental Lung Injury</title><author>Kopp, Ruedger ; Bensberg, Ralf ; Henzler, Dietrich ; Niewels, Anja ; Randerath, Simone ; Rossaint, Rolf ; Kuhlen, Ralf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4371-13ee6b9ee85e166892a286c54907cf0de2d9ef9da2644921ce84fd926dd71303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Acute Lung Injury - therapy</topic><topic>Adult respiratory distress syndrome</topic><topic>Animals</topic><topic>Blood coagulation</topic><topic>Blood Coagulation Tests</topic><topic>Blood Platelets - ultrastructure</topic><topic>Coated Materials, Biocompatible</topic><topic>Cytokines - secretion</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Extracorporeal Membrane Oxygenation - instrumentation</topic><topic>Female</topic><topic>Hemocompatibility testing</topic><topic>Heparin</topic><topic>Materials Testing</topic><topic>Microscopy, Electron, Scanning</topic><topic>Oxygenators</topic><topic>Respiratory Distress Syndrome, Adult - therapy</topic><topic>Swine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kopp, Ruedger</creatorcontrib><creatorcontrib>Bensberg, Ralf</creatorcontrib><creatorcontrib>Henzler, Dietrich</creatorcontrib><creatorcontrib>Niewels, Anja</creatorcontrib><creatorcontrib>Randerath, Simone</creatorcontrib><creatorcontrib>Rossaint, Rolf</creatorcontrib><creatorcontrib>Kuhlen, Ralf</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kopp, Ruedger</au><au>Bensberg, Ralf</au><au>Henzler, Dietrich</au><au>Niewels, Anja</au><au>Randerath, Simone</au><au>Rossaint, Rolf</au><au>Kuhlen, Ralf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemocompatibility of a Miniaturized Extracorporeal Membrane Oxygenation and a Pumpless Interventional Lung Assist in Experimental Lung Injury</atitle><jtitle>Artificial organs</jtitle><addtitle>Artif Organs</addtitle><date>2010-01</date><risdate>2010</risdate><volume>34</volume><issue>1</issue><spage>13</spage><epage>21</epage><pages>13-21</pages><issn>0160-564X</issn><eissn>1525-1594</eissn><abstract>Extracorporeal membrane oxygenation (ECMO) is used for most severe acute respiratory distress syndrome cases in specialized centers. Hemocompatibility of devices depends on the size and modification of blood contacting surfaces as well as blood flow rates. An interventional lung assist using arteriovenous perfusion of a low‐resistance oxygenator without a blood pump (Novalung, Hechingen, Germany) or a miniaturized ECMO with reduced filling volume and a diagonal blood pump (Deltastream, Medos AG, Stolberg, Germany) could optimize hemocompatibility. The aim of the study was to compare hemocompatibility with conventional ECMO. Female pigs were connected to extracorporeal circulation for 24 h after lavage induced lung injury (eight per group). Activation of coagulation and immune system as well as blood cell damage was measured. A P value <0.05 was considered significant. Plasmatic coagulation was slightly activated in all groups demonstrated by increased thrombin‐anti‐thrombin III‐complex. No clinical signs of bleeding or thromboembolism occurred. Thrombelastography revealed decreased clotting capacities after miniaturized ECMO, probably due to significantly reduced platelet count. These resulted in reduced dosage of intravenous heparin. Scanning electron microscopy of oxygenator fibers showed significantly increased binding and shape change of platelets after interventional lung assist. In all groups, hemolysis remained negligible, indicated by low plasma hemoglobin concentration. Interleukin 8 and tumor necrosis factor‐α concentration as well as leukocyte count remained unchanged. Both devices demonstrated adequate hemocompatibility for safe clinical application, although a missing blood pump did not increase hemocompatibility. Further studies seem necessary to analyze the influence of different blood pumps on platelet drop systematically.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>19821813</pmid><doi>10.1111/j.1525-1594.2009.00791.x</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acute Lung Injury - therapy Adult respiratory distress syndrome Animals Blood coagulation Blood Coagulation Tests Blood Platelets - ultrastructure Coated Materials, Biocompatible Cytokines - secretion Extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - instrumentation Female Hemocompatibility testing Heparin Materials Testing Microscopy, Electron, Scanning Oxygenators Respiratory Distress Syndrome, Adult - therapy Swine |
| title | Hemocompatibility of a Miniaturized Extracorporeal Membrane Oxygenation and a Pumpless Interventional Lung Assist in Experimental Lung Injury |
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