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A pulsatile pneumatically driven neonatal extracorporeal membrane oxygenation system using neck vessel cannulas
G Trittenwein1, G Burda, H Trittenwein
1Department of Neonatology and Pediatric Intensive Care, University Children's Hospital, Vienna, Austria. hiluger.trittenwein@htb.at
Artificial Organs
|February 13, 2001
Summary
Pneumatically driven extracorporeal membrane oxygenation (ECMO) systems can be used in neonates via neck vessel cannulas, enabling pulsatile flow for circulatory support. This approach avoids thoracotomy, facilitating emergency applications.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular engineering
- Neonatal physiology
Background:
- Mechanical circulatory support is crucial in posthypoxic circulatory failure.
- Pneumatically driven devices offer pulsatile flow but require invasive cannulation.
- Current methods hinder emergency application in neonates.
Purpose of the Study:
- To evaluate the feasibility of operating a pneumatic assist device-driven extracorporeal membrane oxygenation (ECMO) system using standard neonatal neck vessel cannulas.
- To assess the system's performance under various pressures and native circulation conditions.
Main Methods:
- An in vitro neonatal mock circulation (NMC) model was used.
- A pneumatic Medos VAD 10 ml ventricle and Jostra M8/HEC40 oxygenator formed the ECMO system.
- The system was connected via neonatal neck vessel cannulas to the NMC.
- Flow and pressure were measured under varying settings and loading conditions.
Main Results:
- Pulsatile circulation flow of 100 ml/kg/min was achievable with high pressures at zero native flow.
- Moderate pressures sufficed with 30% native circulation.
- Low preload or high systemic vascular resistance significantly reduced ECMO flow.
- The system operated effectively through neonatal neck vessel cannulas.
Conclusions:
- A pneumatically driven neonatal ECMO system can be successfully operated using common neck vessel cannulas.
- This configuration supports pulsatile flow for neonatal circulatory assistance.
- The approach potentially facilitates emergency ECMO applications in neonates, avoiding thoracotomy.