title: Biocompatibility Assessment of the CentriMag-Novalung Adult ECMO Circuit in a Model of Acute Pulmonary Hypertension.
abstract: Extracorporeal membrane oxygenation (ECMO) is rarely used in patients with severe pulmonary hypertension (PH) as a bridge to lung transplantation. In this study, we assess the blood biocompatibility of the integrated CentriMag-Novalung ECMO system (venoarterial) in an acute model of PH. Severe PH (≥2/3 systemic) was induced in eight sheep through progressive ligation of the main pulmonary artery. System performance, platelet activation, thromboelastography (TEG) parameters, fibrinogen, plasma-free hemoglobin, and total plasma protein were measured at initiation, 3, and 6 hr of support in the ECMO (N = 4) and sham (N = 4) groups. A stable ECMO flow (2.2 ± 0.1 L/min), low transmembrane pressure gradient, and steady blood O2 and CO2 levels were maintained. Platelet activation was low (<4%) in both the groups, whereas platelet responsiveness to agonist (platelet activating factor) was reduced in the sham group when compared with the ECMO group. There were no differences in the TEG parameters, fibrinogen concentration, plasma-free hemoglobin (<10 mg/dl), and plasma total protein between the two groups. The findings of low levels of platelet activation and plfHb suggest adequate blood biocompatibility of the integrated CentriMag-Novalung circuit use for short-term support in a model of PH.
authors.affiliation: From the *Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; †McGowan Institute of Regenerative Medicine, Pittsburgh, Pennsylvania; ‡Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania; §Perfusion Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and ¶Department of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Venkat
authors.initials: V
authors.lastname: Shankarraman
authors.forename: Ergin
authors.initials: E
authors.lastname: Kocyildirim
authors.forename: Salim E
authors.initials: SE
authors.lastname: Olia
authors.forename: Marina V
authors.initials: MV
authors.lastname: Kameneva
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Dzadony
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Maul
authors.forename: Marc A
authors.initials: MA
authors.lastname: Simon
authors.forename: Hunter C
authors.initials: HC
authors.lastname: Champion
authors.forename: William R
authors.initials: WR
authors.lastname: Wagner
authors.forename: Christian A
authors.initials: CA
authors.lastname: Bermudez
mesh_terms: D000208:Acute Disease; D000818:Animals; D004195:Disease Models, Animal; D015199:Extracorporeal Membrane Oxygenation; D006976:Hypertension, Pulmonary / Q000601:surgery*; D008422:Materials Testing; D015539:Platelet Activation / Q000502:physiology; D012756:Sheep; D013916:Thrombelastography