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Li S, Zhou S, Qin X, Zhang S, Zhao XU, Wang K, Liu P. Heparin-modified polyether ether ketone hollow fiber membrane with improved hemocompatibility and air permeability used for extracorporeal membrane oxygenation. Int J Biol Macromol 2024; 279:135481. [PMID: 39251009 DOI: 10.1016/j.ijbiomac.2024.135481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 09/03/2024] [Accepted: 09/06/2024] [Indexed: 09/11/2024]
Abstract
To expand the selection of raw material for fabricating extracorporeal membrane oxygenation (ECMO) and promote its application in lung disease therapy, polyether ether ketone hollow fiber membrane (PEEK-HFM) with designable pore characteristics, desired mechanical performances, and excellent biocompatibility was selected as the potential substitute for existing poly (4-methyl-1-pentene) hollow fiber membrane (PMP-HFM). To address the platelet adhesion and plasma leakage issues with PEEK-HFM, a natural anticoagulant heparin was grafted onto the surface using ultraviolet irradiation. Additionally, to explore the substitutability of the heparin layer while considering cost and scalability, a heparin-like layer composed of copolymers of acrylic acid and sodium p-styrenesulfonate was also constructed on the surface of PEEK-HFM Even though the successful grafting of heparin and heparin-like layers on the PEEK-HFM surface reduced the pore parameters, improvements in surface hydrophilicity also prevented the platelet-adhesion phenomenon and improved the anticoagulant behaviour, making it a viable alternative for commercial PMP-HFMs in ECMO production. Furthermore heparin-modified and heparin-like modified PEEK-HFMs demonstrated similar performance, indicating that synthetic layers can effectively replace natural heparin. This study holds practical and instructive significance for future research and the application of membranes in the development of oxygenators.
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Affiliation(s)
- Shangbo Li
- College of Materials and Chemistry and Chemical Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Shiyi Zhou
- College of Materials and Chemistry and Chemical Engineering, Chengdu University of Technology, Chengdu 610059, China.
| | - Xiangpu Qin
- College of Polymer Science & Engineering, Sichuan University, Chengdu 610065, China
| | - Shengchang Zhang
- College of Polymer Science & Engineering, Sichuan University, Chengdu 610065, China
| | - X U Zhao
- College of Polymer Science & Engineering, Sichuan University, Chengdu 610065, China
| | - Kaixiang Wang
- College of Polymer Science & Engineering, Sichuan University, Chengdu 610065, China
| | - Pengqing Liu
- College of Polymer Science & Engineering, Sichuan University, Chengdu 610065, China
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Fragomeni G, Terzini M, Comite A, Catapano G. The Maximal Pore Size of Hydrophobic Microporous Membranes Does Not Fully Characterize the Resistance to Plasma Breakthrough of Membrane Devices for Extracorporeal Blood Oxygenation. Front Bioeng Biotechnol 2020; 7:461. [PMID: 31998713 PMCID: PMC6966091 DOI: 10.3389/fbioe.2019.00461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) in blood-outside devices equipped with hydrophobic membranes has become routine treatment of respiratory or cardiac failure. In spite of membrane hydrophobicity, significant amounts of plasma water may form in the gas compartment during treatment, an event termed plasma water breakthrough. When this occurs, plasma water occludes some gas pathways and ultimately cripples the oxygenator gas exchange capacity requiring its substitution. This causes patient hemodilution and increases the activation of the patient's immune system. On these grounds, the resistance to plasma water breakthrough is regarded as an important feature of ECMO devices. Many possible events may explain the occurrence of plasma breakthrough. In spite of this, the resistance to plasma breakthrough of ECMO devices is commercially characterized only with respect to the membrane maximal pore size, evaluated by the bubble pressure method or by SEM analysis of membrane surfaces. The discrepancy between the complexity of the events causing plasma breakthrough in ECMO devices (hence determining their resistance to plasma breakthrough), and that claimed commercially has caused legal suits on the occasion of the purchase of large stocks of ECMO devices by large hospitals or regional institutions. The main aim of this study was to identify some factors that contribute to determining the resistance to plasma breakthrough of ECMO devices, as a means to minimize litigations triggered by an improper definition of the requirements of a clinically efficient ECMO device. The results obtained show that: membrane resistance to breakthrough should be related to the size of the pores inside the membrane wall rather than at its surface; membranes with similar nominal maximal pore size may exhibit pores with significantly different size distribution; membrane pore size distribution rather than the maximal pore size determines membrane resistance to breakthrough; the presence of surfactants in the patient's blood (e.g., lipids, alcohol, etc.) may significantly modify the intrinsic membrane resistance to breakthrough, more so the higher the surfactant concentration. We conclude that the requirements of ECMO devices in terms of resistance to plasma breakthrough ought to account for all these factors and not rely only on membrane maximal pore size.
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Affiliation(s)
- Gionata Fragomeni
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Mara Terzini
- Department of Mechanical and Aero-Space Engineering, Politecnico di Torino, Turin, Italy
| | - Antonio Comite
- Department of Chemistry and Industrial Chemistry, University of Genova, Genova, Italy
| | - Gerardo Catapano
- Department of Mechanical, Energy and Management Engineering, University of Calabria, Rende, Italy
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Khosravifard S, Hosseini SS, Boddohi S. Development and tuning of Matrimid membrane oxygenators with improved biocompatibility and gas permeance by plasma treatment. J Appl Polym Sci 2019. [DOI: 10.1002/app.48824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sahar Khosravifard
- Membrane Science and Technology Research Group, Department of Chemical EngineeringTarbiat Modares University Jalal‐Ale‐Ahmad Tehran Iran
| | - Seyed Saeid Hosseini
- Membrane Science and Technology Research Group, Department of Chemical EngineeringTarbiat Modares University Jalal‐Ale‐Ahmad Tehran Iran
- Nanotechnology and Water Sustainability Research Unit, College of Science, Engineering and TechnologyUniversity of South Africa Johannesburg South Africa
| | - Soheil Boddohi
- Department of Biomedical Engineering, Faculty of Chemical EngineeringTarbiat Modares University Jalal‐Ale‐Ahmad Tehran Iran
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Evseev AK, Zhuravel SV, Alentiev AY, Goroncharovskaya IV, Petrikov SS. Membranes in Extracorporeal Blood Oxygenation Technology. MEMBRANES AND MEMBRANE TECHNOLOGIES 2019. [DOI: 10.1134/s2517751619040024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tamari Y, Tortolani A, Lee-Sensiba K. Bloodless Testing for Microporous Membrane Oxygenator Failure: A Preliminary Study. Int J Artif Organs 2018. [DOI: 10.1177/039139889101400307] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Y. Tamari
- Department of Surgery, North Shore University Hospital, Manhasset, New York
- Department of Surgery, Cornell University Medical College, New York, New York - U.S.A
| | - A.J. Tortolani
- Department of Surgery, North Shore University Hospital, Manhasset, New York
- Department of Surgery, Cornell University Medical College, New York, New York - U.S.A
| | - K.J. Lee-Sensiba
- Department of Surgery, North Shore University Hospital, Manhasset, New York
- Department of Surgery, Cornell University Medical College, New York, New York - U.S.A
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Musch G, Verweij M, Bombino M, Banfi G, Fumagalli R, Pesenti A. Small Pore Size Microporous Membrane Oxygenator Reduces Plasma Leakage during Prolonged Extracorporeal Circulation: A Case Report. Int J Artif Organs 2018. [DOI: 10.1177/039139889601900307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Plasma leakage has been regarded as the main technical problem during prolonged extracorporeal circulation (ECC) with microporous membrane oxygenators (MMOs). We report the case of a 15 year old male who underwent long term ECC for ARDS and in whom, by using new MMOs with reduced pore size, we were able to achieve prolonged artificial gas exchange efficiency with minimal plasma leakage. We conclude that reduced pore size MMOs might represent a valuable technical advance in extracorporeal oxygenation therapy.
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Affiliation(s)
- G. Musch
- Istituto di Anestesia e Rianimazione, Università di Milano
| | - M. Verweij
- Istituto di Anestesia e Rianimazione, Università di Milano
| | - M. Bombino
- Servizio di Anestesia e Rianimazione, Ospedale S. Gerardo, Monza, Milano - Italy
| | - G. Banfi
- Istituto di Anestesia e Rianimazione, Università di Milano
| | - R. Fumagalli
- Servizio di Anestesia e Rianimazione, Ospedale S. Gerardo, Monza, Milano - Italy
| | - A. Pesenti
- Istituto di Anestesia e Rianimazione, Università di Milano
- Servizio di Anestesia e Rianimazione, Ospedale S. Gerardo, Monza, Milano - Italy
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Meyns B, Vercaemst L, Vandezande E, Bollen H, Vlasselaers D. Plasma Leakage of Oxygenators in ECMO Depends on the Type of Oxygenator and on Patient Variables. Int J Artif Organs 2018; 28:30-4. [PMID: 15742307 DOI: 10.1177/039139880502800106] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was conducted to identify the causes of plasma leakage of oxygenators in extra corporeal membrane oxygenation (ECMO). From 1996 through 2002, 91 oxygenators were used in 62 patients undergoing ECMO for respiratory and/or cardiac failure. Several types of oxygenators were used (Medtronic Maxima, Minima, PRF, Medos Hilite). Patient variables and variables related to the ECMO set-up were analysed for their relationship with oxygenator failure by a time related multiple regression analysis (Cox). Oxygenator failure occurred in 26% of the cases. The analysis identified the type of oxygenator (p=0.0016), younger patient age (p=0.04) and the number of oxygenators used (p=0.03) as the independent significant risk factors. The type of oxygenator used has the most overwhelming effect (significantly less leakage with the Medos Hilite). In conclusion, leakage of oxygenators is predominantly caused by the type of oxygenator used. Patient variables (younger age and the number of oxygenators used in one patient) are also significant and allude to an inflammatory process as underlying mechanism of plasma leakage.
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Affiliation(s)
- B Meyns
- Department of Cardiac Surgery, Catholic University, Leuven, Belgium.
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Yeager T, Roy S. Evolution of Gas Permeable Membranes for Extracorporeal Membrane Oxygenation. Artif Organs 2017; 41:700-709. [DOI: 10.1111/aor.12835] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Torin Yeager
- Department of Bioengineering and Therapeutic Sciences; University of California; San Francisco CA USA
| | - Shuvo Roy
- Department of Bioengineering and Therapeutic Sciences; University of California; San Francisco CA USA
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Abstract
The natural lung is the organ responsible for oxygen and carbon dioxide exchange between the blood and the outside environment. This function is accomplished by the large surface area and high permeability of the gas exchange interface, the alveolar-capillary membrane. These same features are fundamental to the design of an artificial lung, or oxygenator. Additional lung-like features essential to the design of an ideal oxygenator include the ability to achieve balanced oxygen and carbon dioxide exchange with minimal blood damage and blood activation. The purpose of this review is to present the past and current developments of the oxygenator designs in terms of the structural and functional features of the natural lung as well as the limitations in the ability to mimic the features of the lung because of the lack of appropriate technology.
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Affiliation(s)
- J A Wegner
- University Medical Center, Tucson, AZ 85724, USA
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