Intravascular oxygenation: adjunct in acute respiratory failure

The IVOX device represents an early prototype of an intravascular membrane oxygenator that is capable of transferring significant amounts of O 2 and CO 2. It employs new hollow-fiber membrane technology and thromboresistant coatings that should allow the development of a membrane oxygenator that can be placed either intravascularly or ex vivo to provide significant gas exchange without the adverse effects seen in prior ECMO studies including bleeding from heparinization and plasma breakthrough resulting in the gradual deterioration of gas exchange. It may well be that this technology will eventually supplant conventional mechanical ventilation in the support of patients requiring intensive ventilator assistance or in those that are long term weaning problems, thus avoiding the not insignificant problems associated with high intensity and/or long term mechanical ventilation.