In Vitro and In Vivo Feasibility Study for a Portable VV-ECMO and ECCO2R System

Extracorporeal membrane oxygenation (ECMO) is an established rescue therapy for patients with chronic respiratory failure waiting for lung transplantation (LTx). The therapy inherent immobilization may result in fatigue, consecutive deteriorated prognosis, and even lost eligibility for transplantation. We conducted a feasibility study on a novel system designed for the deployment of a portable ECMO device, enabling the physical exercise of awake patients prior to LTx. The system comprises a novel oxygenator with a directly connected blood pump, a double-lumen cannula, gas blender and supply, as well as control and energy management. In vitro experiments included tests regarding performance, efficiency, and blood damage. A reduced system was tested in vivo for feasibility using a novel large animal model. Six anesthetized pigs were first positioned in supine position, followed by a 45 degrees angle, simulating an upright position of the patients. We monitored performance and vital parameters. All in vitro experiments showed good performance for the respective subsystems and the integrated system. The acute in vivo trials of 8 h duration confirmed the results. The novel portable ECMO-system enables adequate oxygenation and decarboxylation sufficient for, e.g., the physical exercise of designated LTx-recipients. These results are promising and suggest further preclinical studies on safety and efficacy to facilitate translation into clinical application.

Automated summary

Extracorporeal membrane oxygenation (ECMO) is a rescue therapy established for chronic respiratory failure patients waiting for lung transplantation (LTx), but its immobilization may lead to fatigue and deteriorated prognosis. Researchers conducted a feasibility study on a novel system designed to allow awake patients to engage in physical activity prior to surgery. The experiments showed promising results, prompting further preclinical studies for potential clinical application.