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Farling S, Klitzman B, Vesel TP, Cheifetz IM, Straube TL, Deshusses MA. Optimization of the IntraVascular Oxygenator Catheter Using Angular Oscillation. Ann Biomed Eng 2024; 52:638-646. [PMID: 38062312 DOI: 10.1007/s10439-023-03411-x] [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: 06/25/2023] [Accepted: 11/14/2023] [Indexed: 02/13/2024]
Abstract
We demonstrate a methodology which both improves oxygen transport and reduces or eliminates bubble formation in a novel hyperbaric membrane oxygenator catheter model system. Angular oscillations were introduced to a bundle of hollow fiber membranes (HFMs) supplied with hyperbaric 100% oxygen at average gauge pressures up to 0.35 barg. Oscillating bundles enabled delivery of an oxygen flux of up to 400 mL min-1 m-2 in an aqueous solution, a doubling over a previous non-oscillating setup. Similarly, the addition of angular oscillations facilitated a five-fold reduction in pressure to achieve similar oxygen flux. The increased angular speed of oscillation improved flux, while the addition of angular micro-oscillation variations resulted in flux reductions of 7-20% compared to continuous macro-oscillation only, depending on mixing conditions. However, semi-quantitative visual observation demonstrated that angular oscillations reduced or eliminated the instance of oxygen bubble formation on the HFMs. The modeled mass transfer coefficients indicated a quasi linear relationship between rotational velocity and flux, suggesting that faster oscillation speeds could further improve oxygen mass transport allowing for HFM bundles to maintain high oxygen fluxes while eliminating bubble formation. This encourages further development of our compact oxygenating catheter that could be used intravascularly.
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Affiliation(s)
- Stewart Farling
- Department of Civil & Environmental Engineering, Duke University, Durham, NC, USA
| | - Bruce Klitzman
- Kenan Plastic Surgery Research Labs, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Travis P Vesel
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Ira M Cheifetz
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Tobias L Straube
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Marc A Deshusses
- Department of Civil & Environmental Engineering, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
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Straube TL, Rotta AT. Sedation, Relaxation, and a Tube in the Nose: Which Are Associated With Longer Mechanical Ventilation Woes? Early Management Strategies and Outcomes in Critical Bronchiolitis. Pediatr Crit Care Med 2023; 24:1086-1089. [PMID: 38055002 DOI: 10.1097/pcc.0000000000003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Tobias L Straube
- Both authors: Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, NC
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Straube TL, Farling S, Deshusses MA, Klitzman B, Cheifetz IM, Vesel TP. Intravascular Gas Exchange: Physiology, Literature Review, and Current Efforts. Respir Care 2022; 67:480-493. [PMID: 35338096 PMCID: PMC9994006 DOI: 10.4187/respcare.09288] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acute respiratory failure with inadequate oxygenation and/or ventilation is a common reason for ICU admission in children and adults. Despite the morbidity and mortality associated with acute respiratory failure, few proven treatment options exist beyond invasive ventilation. Attempts to develop intravascular respiratory assist catheters capable of providing clinically important gas exchange have had limited success. Only one device, the IVOX catheter, was tested in human clinical trials before development was halted without FDA approval. Overcoming the technical challenges associated with providing safe and effective gas exchange within the confines of the intravascular space remains a daunting task for physicians and engineers. It requires a detailed understanding of the fundamentals of gas transport and respiratory physiology to optimize the design for a successful device. This article reviews the potential benefits of such respiratory assist catheters, considerations for device design, previous attempts at intravascular gas exchange, and the motivation for continued development efforts.
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Affiliation(s)
- Tobias L Straube
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
| | - Stewart Farling
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina
| | - Marc A Deshusses
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina; and Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Bruce Klitzman
- Kenan Plastic Surgery Research Labs, Duke University School of Medicine, Durham, North Carolina; and Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Ira M Cheifetz
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Travis P Vesel
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
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Farling S, Straube TL, Vesel TP, Bottenus N, Klitzman B, Cheifetz IM, Deshusses MA. Development of a novel intravascular oxygenator catheter: Oxygen mass transfer properties across nonporous hollow fiber membranes. Biotechnol Bioeng 2020; 118:345-356. [PMID: 32959889 DOI: 10.1002/bit.27574] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/10/2020] [Accepted: 08/15/2020] [Indexed: 11/06/2022]
Abstract
Despite hypoxic respiratory failure representing a large portion of total hospitalizations and healthcare spending worldwide, therapeutic options beyond mechanical ventilation are limited. We demonstrate the technical feasibility of providing oxygen to a bulk medium, such as blood, via diffusion across nonporous hollow fiber membranes (HFMs) using hyperbaric oxygen. The oxygen transfer across Teflon® membranes was characterized at oxygen pressures up to 2 bars in both a stirred tank vessel (CSTR) and a tubular device mimicking intravenous application. Fluxes over 550 ml min-1 m-2 were observed in well-mixed systems, and just over 350 ml min-1 m-2 in flow through tubular systems. Oxygen flux was proportional to the oxygen partial pressure inside the HFM over the tested range and increased with mixing of the bulk liquid. Some bubbles were observed at the higher pressures (1.9 bar) and when bulk liquid dissolved oxygen concentrations were high. High-frequency ultrasound was applied to detect and count individual bubbles, but no increase from background levels was detected during lower pressure operation. A conceptual model of the oxygen transport was developed and validated. Model parametric sensitivity studies demonstrated that diffusion through the thin fiber walls was a significant resistance to mass transfer, and that promoting convection around the fibers should enable physiologically relevant oxygen supply. This study indicates that a device is within reach that is capable of delivering greater than 10% of a patient's basal oxygen needs in a configuration that readily fits intravascularly.
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Affiliation(s)
- Stewart Farling
- Department of Civil & Environmental Engineering, Duke University, Durham, North Carolina, USA
| | - Tobias L Straube
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Travis P Vesel
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nick Bottenus
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.,Department of Mechanical Engineering, University of Colorado Boulder, Boulder, Colorado, USA
| | - Bruce Klitzman
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.,Kenan Plastic Surgery Research Labs, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ira M Cheifetz
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Marc A Deshusses
- Department of Civil & Environmental Engineering, Duke University, Durham, North Carolina, USA.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Straube TL, Rehder KJ, Turner DA. Predicting Response to PEEP in Mechanically Ventilated Pediatric Patients: What Are the Odds? Respir Care 2020; 64:1319-1321. [PMID: 31575790 DOI: 10.4187/respcare.07371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Tobias L Straube
- Division of Pediatric Critical Care Medicine Department of Pediatrics Duke Children's Hospital Durham, North Carolina
| | - Kyle J Rehder
- Division of Pediatric Critical Care Medicine Department of Pediatrics Duke Children's Hospital Durham, North Carolina
| | - David A Turner
- Division of Pediatric Critical Care Medicine Department of Pediatrics Duke Children's Hospital Durham, North Carolina
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