Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit
Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy method for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients with such instan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Membranes |
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| Online Access: | https://www.mdpi.com/2077-0375/13/10/809 |
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| author | Albert J. Omlor Stefan Caspari Leonie S. Omlor Anna M. Jungmann Marcin Krawczyk Nicole Schmoll Sebastian Mang Frederik Seiler Ralf M. Muellenbach Robert Bals Philipp M. Lepper |
| author_facet | Albert J. Omlor Stefan Caspari Leonie S. Omlor Anna M. Jungmann Marcin Krawczyk Nicole Schmoll Sebastian Mang Frederik Seiler Ralf M. Muellenbach Robert Bals Philipp M. Lepper |
| author_sort | Albert J. Omlor |
| collection | DOAJ |
| description | Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy method for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients with such instances of refractory hypoxemia received a second membrane lung, either in series or in parallel, to overcome the hypoxemia. It remains unclear whether the parallel or serial connection is more effective. Therefore, we used an improved version of our full-flow ECMO mock circuit to test this. The measurements were performed under conditions in which the membrane lungs were unable to completely oxygenate the blood. As a result, only the photometric pre- and post-oxygenator saturations, blood flow and hemoglobin concentration were required for the calculation of oxygen transfer rates. The results showed that for a pre-oxygenator saturation of 45% and a total blood flow of 10 L/min, the serial connection of two identical 5 L rated oxygenators is 17% more effective in terms of oxygen transfer than the parallel connection. Although the idea of using a second membrane lung if refractory hypoxia occurs is intriguing from a physiological point of view, due to the invasiveness of the solution, further investigations are needed before this should be used in a wider clinical setting. |
| first_indexed | 2024-03-10T21:03:35Z |
| format | Article |
| id | doaj.art-7aed06a2e13d456db07c44ab7aa7abe4 |
| institution | Directory Open Access Journal |
| issn | 2077-0375 |
| language | English |
| last_indexed | 2024-03-10T21:03:35Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Membranes |
| spelling | doaj.art-7aed06a2e13d456db07c44ab7aa7abe42023-11-19T17:18:52ZengMDPI AGMembranes2077-03752023-09-01131080910.3390/membranes13100809Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock CircuitAlbert J. Omlor0Stefan Caspari1Leonie S. Omlor2Anna M. Jungmann3Marcin Krawczyk4Nicole Schmoll5Sebastian Mang6Frederik Seiler7Ralf M. Muellenbach8Robert Bals9Philipp M. Lepper10Department of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Anaesthesiology and Critical Care, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine II, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Anaesthesiology and Critical Care, Campus Kassel of the University of Southampton, 34125 Kassel, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyDepartment of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, GermanyExtracorporeal membrane oxygenation (ECMO) is an important rescue therapy method for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients with such instances of refractory hypoxemia received a second membrane lung, either in series or in parallel, to overcome the hypoxemia. It remains unclear whether the parallel or serial connection is more effective. Therefore, we used an improved version of our full-flow ECMO mock circuit to test this. The measurements were performed under conditions in which the membrane lungs were unable to completely oxygenate the blood. As a result, only the photometric pre- and post-oxygenator saturations, blood flow and hemoglobin concentration were required for the calculation of oxygen transfer rates. The results showed that for a pre-oxygenator saturation of 45% and a total blood flow of 10 L/min, the serial connection of two identical 5 L rated oxygenators is 17% more effective in terms of oxygen transfer than the parallel connection. Although the idea of using a second membrane lung if refractory hypoxia occurs is intriguing from a physiological point of view, due to the invasiveness of the solution, further investigations are needed before this should be used in a wider clinical setting.https://www.mdpi.com/2077-0375/13/10/809ECMOmock circuitserialparallelrefractory hypoxemiaoxygenator |
| spellingShingle | Albert J. Omlor Stefan Caspari Leonie S. Omlor Anna M. Jungmann Marcin Krawczyk Nicole Schmoll Sebastian Mang Frederik Seiler Ralf M. Muellenbach Robert Bals Philipp M. Lepper Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit Membranes ECMO mock circuit serial parallel refractory hypoxemia oxygenator |
| title | Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit |
| title_full | Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit |
| title_fullStr | Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit |
| title_full_unstemmed | Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit |
| title_short | Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit |
| title_sort | comparison of serial and parallel connections of membrane lungs against refractory hypoxemia in a mock circuit |
| topic | ECMO mock circuit serial parallel refractory hypoxemia oxygenator |
| url | https://www.mdpi.com/2077-0375/13/10/809 |
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