title: First In Vivo Results of a Novel Pediatric Oxygenator with an Integrated Pulsatile Pump.
abstract: Extracorporeal membrane oxygenation (ECMO) is a pivotal bridge to recovery for cardiopulmonary failure in children. Besides its life-saving quality, it is often associated with severe system-related complications, such as hemolysis, inflammation, and thromboembolism. Novel oxygenator and pump systems may reduce such ECMO-related complications. The ExMeTrA oxygenator is a newly designed pediatric oxygenator with an integrated pulsatile pump minimizing the priming volume and reducing the surface area of blood contact. The aim of our study was to investigate the feasibility and safety of this new ExMeTrA (expansion mediated transport and accumulation) oxygenator in an animal model. During 6 h of extracorporeal circulation (ECC) in pigs, parameters of the hemostatic system including coagulation, platelets and complement activation, and flow rates were investigated. A nonsignificant trend in C3 consumption, thrombin-antithrombin-III (TAT) complex formation and a slight trend in hemolysis were detected. During the ECC, the blood flow was constantly at 500 ml/min using only flexible silicone tubes inside the oxygenator as pulsatile pump. Our data clearly indicate that the hemostatic markers were only slightly influenced by the ExMeTrA oxygenator. Additionally, the oxygenator showed a constant quality of blood flow. Therefore, this novel pediatric oxygenator shows the potential to be used in pediatric and neonatal support with ECMO.
authors.affiliation: From the *Department of Thoracic, Cardiac and Vascular Surgery, Clinical Research Laboratory, University Hospital Tuebingen, Tuebingen, Germany; †Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Aachen University, Aachen, Germany; ‡Department of General, Visceral and Transplant Surgery, University Hospital of Tuebingen, Tuebingen, Germany; and §Herold-Consulting, Business center, Heidelberg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Stang
authors.forename: Ralf
authors.initials: R
authors.lastname: Borchardt
authors.forename: Bernd
authors.initials: B
authors.lastname: Neumann
authors.forename: Julia
authors.initials: J
authors.lastname: Kurz
authors.forename: Sandra
authors.initials: S
authors.lastname: Stoppelkamp
authors.forename: Tim O
authors.initials: TO
authors.lastname: Greiner
authors.forename: Christine
authors.initials: C
authors.lastname: Fahrner
authors.forename: Martin
authors.initials: M
authors.lastname: Schenk
authors.forename: Christian
authors.initials: C
authors.lastname: Schlensak
authors.forename: Maria
authors.initials: M
authors.lastname: Schubert
authors.forename: Henning
authors.initials: H
authors.lastname: Lausberg
authors.forename: Sabine
authors.initials: S
authors.lastname: Herold
authors.forename: Peter C
authors.initials: PC
authors.lastname: Schlanstein
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
authors.forename: Jutta
authors.initials: J
authors.lastname: Arens
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Wendel
mesh_terms: D000818:Animals; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D006403:Hematologic Tests; D023421:Models, Animal; D010107:Oxygenators, Membrane; D011673:Pulsatile Flow; D013552:Swine; D016896:Treatment Outcome