ASAIO Journal最新文献

Arterial Cannula Size Selection for Percutaneous Femoral Venoarterial Extracorporeal Membrane Oxygenation in Children and Young Adults: Solving a Goldilocks Paradox? 儿童和青少年经皮股静脉动脉体外膜氧合的动脉插管尺寸选择：解决金发姑娘悖论？

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-17 DOI: 10.1097/MAT.0000000000002511

Catalina Vargas-Acevedo, Natalie Soszyn, Ernesto Mejia, Jenny E Zablah, Robert Hyslop, Shannon Buckvold, Gareth J Morgan

{"title":"Arterial Cannula Size Selection for Percutaneous Femoral Venoarterial Extracorporeal Membrane Oxygenation in Children and Young Adults: Solving a Goldilocks Paradox?","authors":"Catalina Vargas-Acevedo, Natalie Soszyn, Ernesto Mejia, Jenny E Zablah, Robert Hyslop, Shannon Buckvold, Gareth J Morgan","doi":"10.1097/MAT.0000000000002511","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002511","url":null,"abstract":"The correct arterial cannula size for percutaneous femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) cannulation is imperative for adequate circulatory support. We aimed to describe the relationship between cannula size, predicted arterial size, and vascular complications. Here, we present a single-center cohort of patients who underwent percutaneous femoral VA-ECMO cannulation. A formula using height and body mass index was used to predict the estimated common femoral artery (CFA) diameter and compared it to the cannula size used. The primary endpoint was major vascular complications. Receiver Operating Characteristic (ROC) curve was used to determine the cutoff point for significant cannula size discrepancy (≥2.7 Fr greater than predicted). Twenty-five patients were included, with a median predicted CFA diameter of 5.4mm (16.2 Fr), 1.9 Fr lower than the chosen cannula. Eight patients (32%) had a significant cannula discrepancy with more vascular complications (p = 0.039). ROC analysis confirmed a moderate correlation between cannula discrepancy and major vascular complications (area under the curve [AUC] 0.640, sensitivity of 67%; specificity of 84%) and overall vascular complications (AUC 0.662, sensitivity of 63%; specificity of 88%). Thus, the use of arterial cannulas for percutaneous VA-ECMO that are ≥2.7 Fr larger than the estimated CFA appears to be related to a higher risk of overall vascular complications. The estimated arterial diameter should be considered when selecting the arterial cannula size.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dosing Reliability of Direct Thrombin Inhibitors in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis. 体外膜氧合中直接凝血酶抑制剂的剂量可靠性：系统回顾和荟萃分析。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-17 DOI: 10.1097/MAT.0000000000002512

Patrick M Wieruszewski, Hannah M Brinkman, Jamel P Ortoleva, Juan G Ripoll, Sarah E Pieterick, Katharine E Damico, Subhasis Chatterjee, Erica D Wittwer, Danielle J Gerberi, Jacopo D'Andria Ursoleo, Erin D Wieruszewski, Troy G Seelhammer

{"title":"Dosing Reliability of Direct Thrombin Inhibitors in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis.","authors":"Patrick M Wieruszewski, Hannah M Brinkman, Jamel P Ortoleva, Juan G Ripoll, Sarah E Pieterick, Katharine E Damico, Subhasis Chatterjee, Erica D Wittwer, Danielle J Gerberi, Jacopo D'Andria Ursoleo, Erin D Wieruszewski, Troy G Seelhammer","doi":"10.1097/MAT.0000000000002512","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002512","url":null,"abstract":"Empirical evidence suggests direct thrombin inhibitors (DTIs) produce more favorable hemostatic outcomes than heparin in patients supported by extracorporeal membrane oxygenation (ECMO), yet the exact mechanisms responsible are unknown. We systematically searched databases and registers for studies comparing DTIs to heparin in humans receiving ECMO. A total of 28 studies were identified, most of which (n = 25) used bivalirudin, while the rest (n = 3) used argatroban. In random-effects meta-analysis, DTIs achieved the therapeutic anticoagulation range faster (mean difference = -6.96 hours, 95% confidence interval [CI] = -11.98 to -1.95, p = 0.006) and maintained the therapeutic range for a greater proportion of time (mean difference = 18.6%, 95% CI = 8.78-28.42, p < 0.001) than heparin. Subgroup analysis revealed these effects were similarly significant in adult patients and when bivalirudin was the DTI; however, they were not significant in pediatric patients or when argatroban was the DTI. Sensitivity analysis confirmed robustness of the primary findings in only low-risk of bias studies and in only studies published as full papers. In summary, DTIs-specifically bivalirudin-were associated with faster time to therapeutic anticoagulation and maintained the goal range for a greater percentage of time than heparin during ECMO support.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Support Vascular Access: 3D Printing Custom Cannulas. 体外支持血管通道：3D打印定制套管。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-17 DOI: 10.1097/MAT.0000000000002504

Andrew Zhang, Megha M Jacob, Auldynn J Chambers, Gabriele K Seilo, Sam Blum, Daniela Pelaez-Palacio, Orsolya Lautner-Csorba, Jordan S Blaine, Zoe Vandenberg, George B Mychaliska, Joseph A Potkay, Alvaro Rojas-Peña

{"title":"Extracorporeal Support Vascular Access: 3D Printing Custom Cannulas.","authors":"Andrew Zhang, Megha M Jacob, Auldynn J Chambers, Gabriele K Seilo, Sam Blum, Daniela Pelaez-Palacio, Orsolya Lautner-Csorba, Jordan S Blaine, Zoe Vandenberg, George B Mychaliska, Joseph A Potkay, Alvaro Rojas-Peña","doi":"10.1097/MAT.0000000000002504","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002504","url":null,"abstract":"Extracorporeal life support (ECLS) requires specialized cannulas for vascular access that are dependent on each patient's needs, size, and unique vascular anatomy. There are currently no commercially available drainage cannulas suitable for patients smaller than 1.5 kg. This study presents the development of a novel 6 Fr cannula for blood drainage to be used in these small patients. Cannulas were manufactured using stereolithography three-dimensional (3D) printing on Form 3 and Form 3B printers and tested in vitro using 3% glycerol. Drainage pressure at 100 ml/min was -39 ± 2 and -42.3 ± 9 mm Hg, for Form 3 and Form 3B, respectively. Maximum flow rate and drainage pressures were 185.8 ± 15 ml/min and -80 ± 2 mm Hg and 165 ± 21 ml/min and -85.7 ± 12 mm Hg for Form 3 and Form 3B, respectively. Three Form 3B cannulas were tested in vivo in an ECLS piglet model, the best of which had a maximum blood flow rate of 139 ml/min at -32 mm Hg drainage pressure. Cannulas 3D-printed using the Form 3 and Form 3B printers exhibited appropriate size and flow rates (~100 ml/kg/min) for ECLS needed to support premature patients with minimal complexity in the fabrication process. These cannulas should be optimized in preclinical research using translational models.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood Pump Surface Roughness: Hemocompatibility and Machining Optimization. 血泵表面粗糙度：血液相容性与加工优化。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-17 DOI: 10.1097/MAT.0000000000002501

Hongyu Li, Yiwen Wang, Xuefeng Wu, Lijie Zhou, Lijia Liu, Yuan Fang

{"title":"Blood Pump Surface Roughness: Hemocompatibility and Machining Optimization.","authors":"Hongyu Li, Yiwen Wang, Xuefeng Wu, Lijie Zhou, Lijia Liu, Yuan Fang","doi":"10.1097/MAT.0000000000002501","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002501","url":null,"abstract":"Blood compatibility, defined as a material's ability to maintain blood flow without inducing coagulation or hemolysis, was investigated through surface roughness optimization in blood pump flow channels. This study examines how machining parameters (depth of cut, cutting speed, feed per tooth, and cutting width) affect surface roughness using orthogonal experiments, revealing their descending order of influence. Blood compatibility tests comparing cellular damage and adhesion across varying surface roughness levels demonstrated that rougher titanium alloy surfaces significantly increased hemolysis rates and promoted platelet adhesion, accelerating thrombus formation. Genetic algorithm optimization identified optimal parameters: 80 m/min cutting speed, 0.2 mm depth of cut, 1.25 mm cutting width, and 0.02 mm/tooth feed. These parameters minimize surface roughness while maintaining machining efficiency, crucially enhancing blood pump performance by reducing thrombogenic risks. The established evaluation system and parameter optimization methodology provide practical guidance for manufacturing blood-contacting medical devices with improved hemocompatibility.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimation of Absolute Blood Volume Using Online Dialysate Dilution: More Questions. 在线透析液稀释估计绝对血容量：更多问题。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-17 DOI: 10.1097/MAT.0000000000002502

Daniel Schneditz, Sebastian Mussnig, David Keane, Manfred Hecking, Simon Krenn

引用次数: 0

A Case of Atypical HeartWare Ventricular Assist Device Outflow Graft Obstruction. 非典型心室辅助装置流出部移植物梗阻1例。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-16 DOI: 10.1097/MAT.0000000000002513

Tomonari Uemura, Tomo Yoshizumi, Yasunari Hayashi, Toru Kondo, Ryota Morimoto, Masato Mutsuga

{"title":"A Case of Atypical HeartWare Ventricular Assist Device Outflow Graft Obstruction.","authors":"Tomonari Uemura, Tomo Yoshizumi, Yasunari Hayashi, Toru Kondo, Ryota Morimoto, Masato Mutsuga","doi":"10.1097/MAT.0000000000002513","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002513","url":null,"abstract":"External outflow graft obstruction (EOGO) is a known complication in left ventricular assist devices (LVADs), particularly around limited spaces such as the bend relief in HeartMate pumps. While EOGO in HeartMate 3 commonly occurs due to accumulation of biodebris between the bend relief and outflow graft, the incidence of EOGO in the HeartWare Ventricular Assist Device (HVAD) is much lower (0.006 events per patient-year) than that in HeartMate 3 because of the unique grid-like strain relief structure. We report an atypical case of EOGO in a 59 year old man with previous coronary artery bypass grafting who developed progressive dyspnea and decreased pump flow 4 years after HVAD implantation. Surgical exploration revealed aggressive ingrowth of dense fibrinous tissue into the strain relief, causing outflow graft compression. Pump flow improved dramatically after debridement. This case demonstrates that EOGO can occur in any LVAD when the outflow graft passes through a confined space, such as with dense adhesions due to prior surgery. This case report implies that strategies to prevent EOGO in LVADs may require not only bend relief fenestration to avoid biodebris accumulation but also improvement of confined spaces around the outflow graft such as adhesions after surgery.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-Concentration Hydrogen Delivery During Dialysis Using an Innovative Direct Dissolution Technique: In Vivo Kinetics in a Canine Model. 透析过程中使用创新的直接溶解技术的高浓度氢输送：犬模型的体内动力学。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-15 DOI: 10.1097/MAT.0000000000002508

Masaki Shibuya, Masafumi Fujinaka, Mako Yonezawa, Natsumi Nishimura, Hitoshi Uchinoumi, Kenji Tani, Yukihiro Hitaka, Kimihiko Nakamura, Naohito Isoyama, Zenzo Fujii, Motoaki Sano

{"title":"High-Concentration Hydrogen Delivery During Dialysis Using an Innovative Direct Dissolution Technique: In Vivo Kinetics in a Canine Model.","authors":"Masaki Shibuya, Masafumi Fujinaka, Mako Yonezawa, Natsumi Nishimura, Hitoshi Uchinoumi, Kenji Tani, Yukihiro Hitaka, Kimihiko Nakamura, Naohito Isoyama, Zenzo Fujii, Motoaki Sano","doi":"10.1097/MAT.0000000000002508","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002508","url":null,"abstract":"Hydrogen gas (H₂) shows broad therapeutic potential. Hemodialysis, using large dialysate volumes in contact with blood, presents a promising H₂ delivery method. We developed an innovative system generating hydrogen-enriched dialysate, differing from conventional electrolysis. This system directly dissolves H₂ gas into tap water to produce saturated water, which then undergoes reverse osmosis (RO) for dialysate preparation. Using this system in a canine hemodialysis model with a single dog, we measured H₂ concentrations. High H₂ levels were consistently maintained (approximately 1,600 ppb in RO water; stable approximately 230 ppb in final dialysate). H₂ efficiently diffused into the extracorporeal blood circuit, with outlet concentrations reaching 54.0-67.7% of the dialysate level. However, low systemic arterial concentrations (pulmonary, carotid) indicated significant pulmonary clearance, suggesting H₂ primarily acts locally within the circuit and dialyzer. Compared with traditional electrolyzed water methods, this direct dissolution system delivers substantially higher and more stable H₂ concentrations. Its simpler design and potentially lower installation costs suggest feasibility for widespread clinical adoption. Future studies should explore hemodiafiltration (HDF) to potentially enhance systemic H₂ delivery and evaluate long-term clinical benefits.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Treatment of Extracorporeal Membrane Oxygenation Induced Digital Ischemia in Infants Using Botulinum Toxin Type A. A型肉毒毒素成功治疗体外膜氧合所致婴幼儿手指缺血。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-15 DOI: 10.1097/MAT.0000000000002510

Samantha Huang, Dominick Byrd, Avra Laarakker, Shawhin Shahriari, Gregory Borah

{"title":"Successful Treatment of Extracorporeal Membrane Oxygenation Induced Digital Ischemia in Infants Using Botulinum Toxin Type A.","authors":"Samantha Huang, Dominick Byrd, Avra Laarakker, Shawhin Shahriari, Gregory Borah","doi":"10.1097/MAT.0000000000002510","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002510","url":null,"abstract":"Digital ischemia following extracorporeal membrane oxygenation (ECMO) therapy is a known complication with potential devastating long-term sequela. Onabotulinum toxin type A (BTX-A) has been demonstrated to be effective for digital ischemia in adults with Raynaud's phenomenon. The objective of this study is to describe the use of BTX-A in pediatric and neonatal patients with digital ischemia following ECMO therapy. Three consecutive patients with digital ischemia after ECMO therapy were included. Patient ages ranged from 3 days to 13 months. Twenty-five to 50 units of BTX-A were injected to each affected extremity targeting the areas around the known arterial anatomy of the hands and feet. On post-injection day one, all patients demonstrated improvement in ischemic discoloration. Complete resolution was noted by treatment day 3 in one case and near complete resolution by day 16 in the second. Case 3 expired on hospital day four from an unrelated intracranial hemorrhage. No complications or digital loss were observed. Onabotulinum toxin type A as an off-label treatment for digital ischemia was demonstrated to be safe and effective in pediatric and neonatal patients. Clinical improvement was noted in all patients by post-procedure day one, with two patients demonstrating near to complete resolution within 3 weeks.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Normothermic Machine Perfusion and Inflammatory Mediators Adsorption: First Kidney Transplant Experience. 恒温机灌注和炎症介质吸附：首次肾移植经验。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-11 DOI: 10.1097/MAT.0000000000002503

Duilio Pagano, Rosalia Busà, Margot Lo Pinto, Agita Jukna, Ivan Vella, Sergio Calamia, Salvatore Piazza, Paola Salis, Barbara Buscemi, Pier Giulio Conaldi, Valentina Agnese, Massimo Pinzani, Fabrizio di Francesco, Sergio Li Petri, Simone D Scilabra, Salvatore Gruttadauria

{"title":"Normothermic Machine Perfusion and Inflammatory Mediators Adsorption: First Kidney Transplant Experience.","authors":"Duilio Pagano, Rosalia Busà, Margot Lo Pinto, Agita Jukna, Ivan Vella, Sergio Calamia, Salvatore Piazza, Paola Salis, Barbara Buscemi, Pier Giulio Conaldi, Valentina Agnese, Massimo Pinzani, Fabrizio di Francesco, Sergio Li Petri, Simone D Scilabra, Salvatore Gruttadauria","doi":"10.1097/MAT.0000000000002503","DOIUrl":"10.1097/MAT.0000000000002503","url":null,"abstract":"Kidney transplantation faces challenges due to the shortage of donor organs, leading to the increased use of extended criteria donor (ECD) organs. Recent advancements in ex-situ organ perfusion technologies have facilitated the use of ECD kidneys by preserving organs in near-physiological conditions to tackle ischemia-reperfusion injury (IRI), a process that leads to long-term graft injury. This study focuses on the application of an inflammatory mediators' removal (IMR) integrated in a normothermic machine perfusion (NMP) for the recovery of an ECD kidney before transplantation. This IMR device, designed to adsorb inflammatory molecules, demonstrated effective removal of cytokines during the perfusion process. An ECD kidney underwent 320 minutes of NMP, allowing detailed organ viability assessments and cytokine modulation. A significant volume of urine output and successful post-transplantation outcomes, with no delayed graft function (DGF), highlight the efficacy of this approach. Additionally, the adsorption of inflammatory cytokines was characterized by concentration-dependent removal, suggesting a balanced modulation of both pro- and anti-inflammatory responses. The integration of IMR device into the perfusion process might offer a promising option for evaluating organ viability and mitigating IRI. Further studies are needed to explore the long-term clinical impact of this approach on graft survival and function.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Additional Carbon Dioxide Removal by Oxygenated Dialysis Fluid: Insights for the Development of a Novel Lung and Kidney Assist Device. 含氧透析液去除额外的二氧化碳：一种新型肺和肾辅助装置的发展见解。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-07-10 DOI: 10.1097/MAT.0000000000002505

Ana Martins Costa, Laura Guarino, Frank Ruben Halfwerk, Bettina Wiegmann, Jutta Arens

{"title":"Additional Carbon Dioxide Removal by Oxygenated Dialysis Fluid: Insights for the Development of a Novel Lung and Kidney Assist Device.","authors":"Ana Martins Costa, Laura Guarino, Frank Ruben Halfwerk, Bettina Wiegmann, Jutta Arens","doi":"10.1097/MAT.0000000000002505","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002505","url":null,"abstract":"RenOx, a novel artificial lung and kidney assist device, combines gas exchange and dialysis fibers for integrated respiratory and renal support, with dialysis fibers intended for toxin clearance and filtration. However, when kidney support is not needed, dialysis fibers could be repurposed for additional respiratory support for patients in exacerbated cases, and to compensate losses in CO2 transfer caused by the partial replacement of gas exchange fibers by dialysis fibers. We analyzed the feasibility of extracorporeal gas transfer via dialysis membranes with fully oxygenated and decarboxylated dialysis fluid in a closed circuit, quantifying O2 and CO2 exchange during standardized in-vitro tests with blood. Oxygenated dialysate was pumped through a dialyzer with a similar dialysis fiber area (0.6 m2) to the RenOx (adult size). Gas transfer efficiency was evaluated at blood-to-dialysate flow ratios of 1, 3, and 6. Average CO2 removal from 12 to 35 ml/Lblood was achieved by adjusting blood-to-dialysate flow ratio, approaching the full metabolic requirement of adult patients (40 ml/Lblood). Maximum oxygen supply was 15 ml/Lblood. Blood pH and hematocrit were within physiological range. This study proposes a simple method to enhance lung support in the RenOx, advancing research on CO2 removal by dialysis.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0