Nicholas J. Shea1, Mauer Biscotti2, Gopal Singh3, Alanna B. Taubman4, Matthew Bacchetta5
As clinical experience with extracorporeal life support (ECLS) continues to grow, pulmonary hypertension (PH) remains a potential target for intervention and investigation. PH is a rare but severe, progressive disease that can lead to right heart failure and death. ECLS has the potential to ameliorate both the pulmonary and cardiac dysfunction associated with PH, and thus provide a life saving intervention in this disease.
In this study, we assessed the blood biocompatibility of the SYNERGY micropump in conjunction with a Quadrox D oxygenator in a novel oxygenator-right ventricular assist device (OxyRVAD) extracorporeal membrane oxygenation (ECMO) circuit in a swine model of acute PH. Four pigs were placed on OxyRVAD ECMO. PH was induced by banding the pulmonary artery. After banding, mean pulmonary artery pressure (mPAP) increased from 17 mmHg to 39 mmHg.
All animals survived 6 hours without catastrophic biocompatibility issues. There were no significant differences in hemoglobin, plasma-free hemoglobin, or platelets from baseline. Platelet activation – assessed by plasma P-selectin – did not increase during the run. Indirect measurements of hemolysis were assessed by total bilirubin and lactate dehydrogenase. Total bilirubin did not change significantly. The average increase in lactate dehydrogenase was significant.Fibrinogen and D-dimer levels were significantly decreased from baseline.
OxyRVAD showed no catastrophic failures in this short-term test. Micropump OxyRVADs may have a role in the management of PH.
Keywords— extracorporeal membrane oxygenation, ECMO, SYNERGY micropump, OxyRVAD
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