Carmeda surface heparinization in neonatal ECMO systems: long-term experiments in a sheep model

Area of Science:

• Biomaterials Science
• Cardiovascular Engineering
• Neonatal Intensive Care

Background:

• Extracorporeal membrane oxygenation (ECMO) is a life-support technology for neonates with severe cardiorespiratory failure.
• Systemic heparinization is crucial for preventing circuit thrombosis but carries risks of bleeding.
• Developing thromboresistant biomaterials is essential to improve ECMO safety and efficacy.

Purpose of the Study:

• To evaluate the thromboresistance of Carmeda heparin-coated neonatal ECMO circuits compared to non-coated circuits.
• To assess the impact of heparin coating on clotting activation and fibrin monomer formation during ECMO.
• To determine the potential of heparin coating to reduce systemic heparinization requirements in neonatal ECMO.

Main Methods:

• A sheep model was used to compare three Carmeda heparin-coated ECMO systems (45-96 hours runtime) with three non-coated systems (12-66 hours runtime).
• Standardized flow rates (200 ml/min) and activated clotting time (ACT ≈ 120 seconds) were maintained.
• Clotting assessment and detection of fibrin monomers were performed at the end of experiments.

Main Results:

• Heparin-coated systems exhibited minimal clotting, whereas non-coated systems showed significant clotting throughout.
• Fibrin monomers were detected after 24 hours in the heparin-coated group but within 60 minutes in the non-coated group.
• The Carmeda heparin coating demonstrated a clear thromboresistant effect.

Conclusions:

• Carmeda heparin coating provides significant thromboresistance for neonatal ECMO circuits.
• Heparin coating effectively reduces thrombus formation and activation of the coagulation cascade.
• This technology may reduce the reliance on systemic heparinization in neonatal ECMO, enhancing patient safety.