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Arterial Line With Gas Extraction Membrane With Hypobaric Oxygen Flow: Gme Elimination On Ecmo (the Membranas Devices)
Ignazio Condello, Sr..
Anthea Hospital, Bari, Italy.
BACKGROUND: Gaseous micro-emboli (GME) are a persistent risk in extracorporeal circulation systems, including extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB). These emboli can lead to severe complications, such as neurological damage and organ dysfunction, highlighting the urgent need for innovative solutions to mitigate this risk.ECMO is particularly associated with a high incidence of thrombotic phenomena within the oxygenator,which can result in performance deficits, reduced efficiency, and potentially fatal outcomes. According to ELSO (Extracorporeal Life Support Organization) registry data, it is estimated that oxygenator thrombosis affects up to 15-20% of ECMO procedures, contributing significantly to morbidity and mortality.
METHODS: This study introduces and evaluates a novel device: a Polyvinyl Chloride (PVC) arterial line featuring a gas extraction membrane combined with a hypobaric oxygen flow system. This arterial line is designed with an outer oxygen flow maintained at hypobaric pressure (<680 mmHg), separated from the blood flow by a semi-permeable silicone membrane. This configuration enables the selective removal of gaseous emboli from the bloodstream, transferring them into the hypobaric oxygen flow and significantly reducing embolic load.
RESULTS: Initial laboratory tests and theoretical models demonstrate the effectiveness of the hypobaric technique in decreasing gaseous micro-emboli, showcasing its potential to improve safety in ECMO and CPB applications.
CONCLUSIONS:The device offers significant advantages over traditional filtration methods, including improved efficiency in GME removal, reduced hemodynamic resistance, and compatibility with low-anticoagulation settings. This study provides a foundation for future research and development, with the prospect of advancing extracorporeal circulation technology and transforming the standard of care in clinical practice
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