In Vitro and In Vivo Feasibility Study for a Portable VV-ECMO and ECCO₂R System

Area of Science:

• Cardiovascular and Respiratory Systems Engineering
• Biomedical Engineering
• Transplantation Medicine

Background:

• Extracorporeal membrane oxygenation (ECMO) is a critical rescue therapy for chronic respiratory failure preceding lung transplantation (LTx).
• Immobilization during conventional ECMO therapy can lead to patient deconditioning, negatively impacting prognosis and LTx eligibility.
• There is a need for ECMO systems that permit patient mobility and exercise prior to LTx.

Purpose of the Study:

• To assess the feasibility of a novel portable ECMO system designed for physical exercise in awake patients awaiting LTx.
• To evaluate the performance, efficiency, and hemocompatibility of the portable ECMO system.

Main Methods:

• Development and in vitro testing of a portable ECMO system including a novel oxygenator, blood pump, double-lumen cannula, gas blender, and control systems.
• In vivo feasibility study using a large animal model (anesthetized pigs) in supine and upright (45°) positions over 8 hours.
• Monitoring of system performance, vital parameters, oxygenation, and decarboxylation.

Main Results:

• In vitro experiments demonstrated satisfactory performance and efficiency for all subsystems and the integrated portable ECMO system.
• In vivo trials confirmed the system's ability to maintain adequate oxygenation and decarboxylation in a simulated upright position.
• The system proved feasible for supporting physiological demands, including those during physical exercise.

Conclusions:

• The novel portable ECMO system is a promising technology for enabling physical exercise in LTx candidates.
• This system has the potential to improve patient conditioning and outcomes prior to lung transplantation.
• Further preclinical studies are warranted to evaluate safety and efficacy for clinical translation.