1
|
Goh T, Gao L, Singh J, Totaro R, Carey R, Yang K, Cartwright B, Dennis M, Ju LA, Waterhouse A. Platelet Adhesion and Activation in an ECMO Thrombosis-on-a-Chip Model. Adv Sci (Weinh) 2024:e2401524. [PMID: 38757670 DOI: 10.1002/advs.202401524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/03/2024] [Indexed: 05/18/2024]
Abstract
Use of extracorporeal membrane oxygenation (ECMO) for cardiorespiratory failure remains complicated by blood clot formation (thrombosis), triggered by biomaterial surfaces and flow conditions. Thrombosis may result in ECMO circuit changes, cause red blood cell hemolysis, and thromboembolic events. Medical device thrombosis is potentiated by the interplay between biomaterial properties, hemodynamic flow conditions and patient pathology, however, the contribution and importance of these factors are poorly understood because many in vitro models lack the capability to customize material and flow conditions to investigate thrombosis under clinically relevant medical device conditions. Therefore, an ECMO thrombosis-on-a-chip model is developed that enables highly customizable biomaterial and flow combinations to evaluate ECMO thrombosis in real-time with low blood volume. It is observed that low flow rates, decelerating conditions, and flow stasis significantly increased platelet adhesion, correlating with clinical thrombus formation. For the first time, it is found that tubing material, polyvinyl chloride, caused increased platelet P-selectin activation compared to connector material, polycarbonate. This ECMO thrombosis-on-a-chip model can be used to guide ECMO operation, inform medical device design, investigate embolism, occlusion and platelet activation mechanisms, and develop anti-thrombotic biomaterials to ultimately reduce medical device thrombosis, anti-thrombotic drug use and therefore bleeding complications, leading to safer blood-contacting medical devices.
Collapse
Affiliation(s)
- Tiffany Goh
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Heart Research Institute, Newtown, NSW, 2042, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Lingzi Gao
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Heart Research Institute, Newtown, NSW, 2042, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jasneil Singh
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Heart Research Institute, Newtown, NSW, 2042, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Richard Totaro
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Intensive Care Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Ruaidhri Carey
- Intensive Care Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Kevin Yang
- Intensive Care Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Bruce Cartwright
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Anaesthetics Department, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia
| | - Mark Dennis
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Cardiology Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Lining Arnold Ju
- Heart Research Institute, Newtown, NSW, 2042, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, NSW, 2008, Australia
| | - Anna Waterhouse
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Sydney, NSW, 2006, Australia
| |
Collapse
|
2
|
Fleck E, Keck C, Ryszka K, Zhang A, Atie M, Maddox S, Potkay J. Toward 3D printed microfluidic artificial lungs for respiratory support. Lab Chip 2024; 24:955-965. [PMID: 38275173 PMCID: PMC10863644 DOI: 10.1039/d3lc00814b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Microfluidic artificial lungs (μALs) are a new class of membrane oxygenators. Compared to traditional hollow-fiber oxygenators, μALs closely mimic the alveolar microenvironment due to their size-scale and promise improved gas exchange efficiency, hemocompatibility, biomimetic blood flow networks, and physiologically relevant blood vessel pressures and shear stresses. Clinical translation of μALs has been stalled by restrictive microfabrication techniques that limit potential artificial lung geometries, overall device size, and throughput. To address these limitations, a high-resolution Asiga MAX X27 UV digital light processing (DLP) 3D printer and custom photopolymerizable polydimethylsiloxane (PDMS) resin were used to rapidly manufacture small-scale μALs via vat photopolymerization (VPP). Devices were designed in SOLIDWORKS with 500 blood channels and 252 gas channels, where gas and blood flow channels were oriented orthogonally and separated by membranes on the top and bottom, permitting two-sided gas exchange. Successful devices were post-processed to remove uncured resin from microchannels and assembled with external tubing in preparation for gas exchange performance testing with ovine whole blood. 3D printed channel dimensions were 172 μm-tall × 320 μm-wide, with 62 μm-thick membranes and 124 μm-wide support columns. Measured outlet blood oxygen saturation (SO2) agreed with theoretical models and rated flow of the device was 1 mL min-1. Blood side pressure drop was 1.58 mmHg at rated flow. This work presents the highest density of 3D printed microchannels in a single device, one of the highest CO2 transfer efficiencies of any artificial lung to date, and a promising approach to translate μALs one step closer to the clinic.
Collapse
Affiliation(s)
- Elyse Fleck
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Charlise Keck
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Karolina Ryszka
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Andrew Zhang
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Michael Atie
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Sydney Maddox
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Joseph Potkay
- ECLS Laboratory, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| |
Collapse
|
3
|
Roberts TR, Persello A, Harea GT, Vedula EM, Isenberg BC, Zang Y, Santos J, Borenstein JT, Batchinsky AI. First 24 Hour-Long Intensive Care Unit Testing of a Clinical-Scale Microfluidic Oxygenator in Swine: A Safety and Feasibility Study. ASAIO J 2024:00002480-990000000-00382. [PMID: 38165978 DOI: 10.1097/mat.0000000000002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
Microfluidic membrane oxygenators are designed to mimic branching vasculature of the native lung during extracorporeal lung support. To date, scaling of such devices to achieve clinically relevant blood flow and lung support has been a limitation. We evaluated a novel multilayer microfluidic blood oxygenator (BLOx) capable of supporting 750-800 ml/min blood flow versus a standard hollow fiber membrane oxygenator (HFMO) in vivo during veno-venous extracorporeal life support for 24 hours in anesthetized, mechanically ventilated uninjured swine (n = 3/group). The objective was to assess feasibility, safety, and biocompatibility. Circuits remained patent and operated with stable pressures throughout 24 hours. No group differences in vital signs or evidence of end-organ damage occurred. No change in plasma free hemoglobin and von Willebrand factor multimer size distribution were observed. Platelet count decreased in BLOx at 6 hours (37% dec, P = 0.03), but not in HFMO; however, thrombin generation potential was elevated in HFMO (596 ± 81 nM·min) versus BLOx (323 ± 39 nM·min) at 24 hours (P = 0.04). Other coagulation and inflammatory mediator results were unremarkable. BLOx required higher mechanical ventilator settings and showed lower gas transfer efficiency versus HFMO, but the stable device performance indicates that this technology is ready for further performance scaling and testing in lung injury models and during longer use conditions.
Collapse
Affiliation(s)
- Teryn R Roberts
- From the Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas
| | - Antoine Persello
- From the Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas
| | - George T Harea
- From the Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas
| | - Else M Vedula
- Bioengineering Division, Draper, Cambridge, Massachusetts
| | | | - Yanyi Zang
- From the Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas
| | - Jose Santos
- Bioengineering Division, Draper, Cambridge, Massachusetts
| | | | - Andriy I Batchinsky
- From the Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas
| |
Collapse
|
4
|
Seo S, Kim T. Gas transport mechanisms through gas-permeable membranes in microfluidics: A perspective. Biomicrofluidics 2023; 17:061301. [PMID: 38025658 PMCID: PMC10656118 DOI: 10.1063/5.0169555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Gas-permeable membranes (GPMs) and membrane-like micro-/nanostructures offer precise control over the transport of liquids, gases, and small molecules on microchips, which has led to the possibility of diverse applications, such as gas sensors, solution concentrators, and mixture separators. With the escalating demand for GPMs in microfluidics, this Perspective article aims to comprehensively categorize the transport mechanisms of gases through GPMs based on the penetrant type and the transport direction. We also provide a comprehensive review of recent advancements in GPM-integrated microfluidic devices, provide an overview of the fundamental mechanisms underlying gas transport through GPMs, and present future perspectives on the integration of GPMs in microfluidics. Furthermore, we address the current challenges associated with GPMs and GPM-integrated microfluidic devices, taking into consideration the intrinsic material properties and capabilities of GPMs. By tackling these challenges head-on, we believe that our perspectives can catalyze innovative advancements and help meet the evolving demands of microfluidic applications.
Collapse
Affiliation(s)
- Sangjin Seo
- Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), 50 UNIST-gil, Ulsan 44919, Republic of Korea
| | - Taesung Kim
- Author to whom correspondence should be addressed:. Tel.: +82-52-217-2313. Fax: +82-52-217-2409
| |
Collapse
|
5
|
Setty AA, Chiang TY, Santos JA, Isenberg BC, Vedula EM, Keating RA, Sutherland DW, Borenstein JT. Toward microfluidic integration of respiratory and renal organ support in a single cartridge. Artif Organs 2023; 47:1442-1451. [PMID: 37376726 DOI: 10.1111/aor.14603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Extracorporeal organ assist devices provide lifesaving functions for acutely and chronically ill patients suffering from respiratory and renal failure, but their availability and use is severely limited by an extremely high level of operational complexity. While current hollow fiber-based devices provide high-efficiency blood gas transfer and waste removal in extracorporeal membrane oxygenation (ECMO) and hemodialysis, respectively, their impact on blood health is often highly deleterious and difficult to control. Further challenges are encountered when integrating multiple organ support functions, as is often required when ECMO and ultrafiltration (UF) are combined to deal with fluid overload in critically ill patients, necessitating an unwieldy circuit containing two separate cartridges. METHODS We report the first laboratory demonstration of simultaneous blood gas oxygenation and fluid removal in single microfluidic circuit, an achievement enabled by the microchannel-based blood flow configuration of the device. Porcine blood is flowed through a stack of two microfluidic layers, one with a non-porous, gas-permeable silicone membrane separating blood and oxygen chambers, and the other containing a porous dialysis membrane separating blood and filtrate compartments. RESULTS High levels of oxygen transfer are measured across the oxygenator, while tunable rates of fluid removal, governed by the transmembrane pressure (TMP), are achieved across the UF layer. Key parameters including the blood flow rate, TMP and hematocrit are monitored and compared with computationally predicted performance metrics. CONCLUSIONS These results represent a model demonstration of a potential future clinical therapy where respiratory support and fluid removal are both realized through a single monolithic cartridge.
Collapse
Affiliation(s)
- Aakash A Setty
- Bioengineering Division, Draper, Cambridge, Massachusetts, USA
| | - Tzu Y Chiang
- Bioengineering Division, Draper, Cambridge, Massachusetts, USA
| | - Jose A Santos
- Bioengineering Division, Draper, Cambridge, Massachusetts, USA
| | | | - Else M Vedula
- Bioengineering Division, Draper, Cambridge, Massachusetts, USA
| | - Rose A Keating
- Bioengineering Division, Draper, Cambridge, Massachusetts, USA
| | | | | |
Collapse
|