A portable cardiopulmonary bypass/extracorporeal membrane oxygenation system for the induction and reversal of profound hypothermia: feasibility study in a Swine model of lethal injuries.
The Cleveland Clinic Foundation's (CCF) cardiopulmonary bypass/extracorporeal membrane oxygenation (CPB/ECMO) system capabilities were tested in a hypothermia trauma management feasibility study in a porcine animal model at the Uniformed Services University of the Health Sciences (USUHS, Bethesda, MD, U.S.A.). In this survival series, the CCF system was used in a simulated forward lines combat casualty application where lethal uncontrolled hemorrhage from major vascular injuries was repaired under a state of profound hypothermic arrest (suspended animation), followed by recovery and monitoring in an intensive care unit (ICU) setting. The animals were monitored for survival, neurological impact, cognitive functions, organ damage, and delayed complications over 3 weeks. A survival rate of 83% matched rates previously found using conventional equipment. Neurological findings, organ dysfunction, and complication rates also were no different from previous studies using standard equipment. Successful survival results demonstrated that the CCF CPB/ECMO system could be used to induce a period of profound hypothermic arrest for the repair of lethal traumatic injuries. The logistical advantages of this system make it an attractive choice for use in austere settings and during transport.
Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. casasf@ccf.org
Fernando
F
Casas
Hasan
H
Alam
Andrew
A
Reeves
Zhang
Z
Chen
William A
WA
Smith
D000818:Animals; D001808:Blood Vessels / Q000293:injuries; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D004195:Disease Models, Animal; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D007036:Hypothermia, Induced / Q000295:instrumentation*; D012771:Shock, Hemorrhagic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D013552:Swine; D013997:Time Factors