A novel method for long-term respiratory support

The authors designed a new extracorporeal membrane oxygenation (ECMO) method using a right ventricular assist device (RVAD) system and a membrane oxygenator (MO). An air-driven diaphragm type RVAD was implanted between the right atrium and the pulmonary artery in five goats, and an MO was set on the outlet conduit of the RVAD 2 weeks postoperatively. The MOs used in this study are silicon sheet MOs and prototype MOs using a novel multilayered composite membrane. Respiratory support with this system, under systemic heparinization, could be conducted for 4-8 days without major problems. This method solved several difficulties with ECMO, such as surgical bleeding, serum leakage, destruction of the blood components from the pump system, inadequate bypass flow, and fatal systemic thrombosis. This method is suitable for long-term respiratory support, especially as a bridge before lung or heart-lung transplantation.