title: In Vivo Testing of Extracorporeal Membrane Ventilators: iLA-Activve Versus Prototype I-Lung.
abstract: A side-by-side comparison of the decarboxylation efficacy of two pump-driven venovenous extracorporeal lung assist devices, i.e., a first prototype of the new miniaturized ambulatory extracorporeal membrane ventilator, I-lung versus the commercial system iLA-activve for more than a period of 72 hours in a large animal model. Fifteen German Landrace pigs were anesthetized and underwent mechanical hypoventilation to induce severe hypercapnia. Decarboxylation was accomplished by either the I-lung or the iLA-activve via a double lumen catheter in the jugular vein. Sham-operated pigs were not connected to extracorporeal devices. Cardiovascular, respiratory, and metabolic parameters were continuously monitored, combined with periodic arterial blood sampling for subsequent clinical blood diagnostics, such as gas exchange, hemolysis, coagulation parameters, and cytokine profiles. At the termination of the studies, lung tissue was harvested and examined histologically for pulmonary morphology and leukocyte tissue infiltration. Both extracorporeal devices showed high and comparable efficacy with respect to carbon dioxide elimination for more than 72 hours and were not associated with either bleeding events or clotting disorders. Pigs of both groups showed cardiovascular and hemodynamic stability without marked differences to sham-operated animals. Groups also did not differ in terms of inflammatory and metabolic parameters. We established a preclinical in vivo porcine model for comparative long-term testing of I-lung and iLA-activve. The I-lung prototype proved to be safe and feasible, providing adequate decarboxylation without any adverse events. Once translated into the clinical treatment, the new miniaturized and transportable I-lung device might represent a promising tool for treating awake and mobilized patients with decompensated pulmonary disorders.
authors.affiliation: From the *Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany; †Department of General, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, Rostock, Germany; ‡Clinic for Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany; §Novalung GmbH, Heilbronn, Germany; ¶Institute of Medical Microbiology, Virology, and Hygiene, Rostock University Medical Center, Rostock, Germany; ‖Clinic for Anesthesiology and Intensive Care Medicine, Südstadtklinikum Rostock, Germany; and #Department of Bioengineering, Temple University, Philadelphia, Pennsylvania.
authors.forename: Sabine
authors.initials: S
authors.lastname: Kischkel
authors.forename: Stefan
authors.initials: S
authors.lastname: Bergt
authors.forename: Beate
authors.initials: B
authors.lastname: Brock
authors.forename: Johan
authors.initials: J
authors.lastname: von Grönheim
authors.forename: Anne
authors.initials: A
authors.lastname: Herbst
authors.forename: Marc-Jonas
authors.initials: MJ
authors.lastname: Epping
authors.forename: Georg
authors.initials: G
authors.lastname: Matheis
authors.forename: Esther
authors.initials: E
authors.lastname: Novosel
authors.forename: Joerg
authors.initials: J
authors.lastname: Schneider
authors.forename: Philipp
authors.initials: P
authors.lastname: Warnke
authors.forename: Andreas
authors.initials: A
authors.lastname: Podbielski
authors.forename: Jan P
authors.initials: JP
authors.lastname: Roesner
authors.forename: Peter I
authors.initials: PI
authors.lastname: Lelkes
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vollmar
mesh_terms: D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D003653:Decarboxylation; D015199:Extracorporeal Membrane Oxygenation; D008171:Lung Diseases / Q000628:therapy*; D023421:Models, Animal; D010100:Oxygen / Q000097:blood; D013552:Swine; D012122:Ventilators, Mechanical
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen