期刊
JOURNAL OF CONTROLLED RELEASE
卷 279, 期 -, 页码 336-344出版社
ELSEVIER
DOI: 10.1016/j.jconrel.2018.04.017
关键词
Carbon monoxide; Therapeutic gas; Extracorporeal membrane oxygenation
资金
- German Research Foundation (DFG) [GO 2158/6-1, ME 3820/8-1, WO 2209/2-1]
- Alexander von Humboldt foundation
- Bavarian Ministry of Economic Affairs and Media, Energy and Technology (Validierungsforderung) [41-6560/9/1]
Carbon monoxide (CO) has demonstrated therapeutic potential in multiple inflammatory conditions including intensive care applications such as organ transplantation or sepsis. Approaches to translate these findings into future therapies, however, have been challenged by multiple hurdles including handling and toxicity issues associated with systemic CO delivery. Here, we describe a membrane-controlled Extracorporeal Carbon Monoxide Release System (ECCORS) for easy implementation into Extracorporeal Membrane Oxygenation (ECMO) setups, which are being used to treat cardiac and respiratory diseases in various intensive care applications. Functionalities of the ECCORS were investigated in a pig model of veno-arterial ECMO. By precisely controlling CO generation and delivery as a function of systemic carboxyhemoglobin levels, the system allows for an immediate onset of therapeutic CO-levels while preventing CO-toxicity. Systemic carboxyhemoglobin levels were profiled in real-time by monitoring exhaled CO levels as well as by pulse oximetry, enabling self-contained and automatic feedback control of CO generation within ECCORS. Machine learning based mathematical modeling was performed to increase the predictive power of this approach, laying foundation for high precision systemic CO delivery concepts of tomorrow.
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