Single double-lumen venous-venous pump-driven extracorporeal lung membrane support

Area of Science:

• Cardiovascular and Respiratory System Physiology
• Biomedical Engineering
• Extracorporeal Life Support

Background:

• Venovenous extracorporeal membrane oxygenation (ECMO) is a life-support technology.
• Optimizing ECMO circuits for prolonged use is crucial for patient outcomes.
• Investigating novel configurations for ECMO is essential for advancing critical care.

Purpose of the Study:

• To assess the safety and feasibility of 72-hour total respiratory support using a specific pump-driven venovenous extracorporeal lung membrane (ECMO) system.
• To evaluate the efficacy of this ECMO configuration in pigs.
• To determine the impact of cannula insertion site and size on the system's performance.

Main Methods:

• Twelve pigs underwent initial mechanical ventilation.
• A Novalung extracorporeal lung membrane was connected via a double-lumen cannula to the femoral or jugular vein.
• Ventilation was reduced to near-apneic levels, and pump flow was optimized over 72 hours, with continuous monitoring of physiological parameters.

Main Results:

• The ECMO circuit achieved a mean blood flow of 2.16 L/min, providing effective oxygenation and carbon dioxide removal.
• Optimal respiratory support was maintained throughout the 72-hour period.
• No significant inflammatory, cellular, or coagulatory responses were observed, irrespective of cannula route or size.

Conclusions:

• The investigated pump-driven venovenous ECMO circuit offers safe and effective total respiratory support for up to 72 hours.
• The system demonstrates minimal adverse physiological effects, including hemodynamic, coagulatory, cellular, and inflammatory responses.
• This technology shows promise for prolonged respiratory support applications.