The IVOX (intravascular oxygenator) is an intracorporeal, hollow-fibre membrane oxygenator and carbon dioxide (CO 2) removal device. The IVOX is surgically placed into the vena cava via a femoral or jugular venotomy. Oxygen (O 2) is pulled through the hollow fibres by a vacuum pump controlled by a flow meter. There is no extracorporeal circulation of blood. Gas exchange occurs as the patient's blood flows over several hundred hollow fibres. Inlet and outlet gas conduits exit a small skin incision for inflow of 0 2 and outflow of CO 2. Studies in sheep show that the IVOX can support approximately 30% of gas exchange requirements. The position of the IVOX in the vena cava does not affect haemodynamics or cause thromboembolic complications. It can remain in place for up to 22 days without affecting haematologic or blood chemistry parameters. The IVOX is currently undergoing clinical trials at selected medical centres in patients with acute respiratory failure.
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http://dx.doi.org/10.1177/026765919100600409 | DOI Listing |
Macromol Biosci
January 2025
Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain.
Blood-contacting medical devices, especially extracorporeal membrane oxygenators (ECMOs), are highly susceptible to surface-induced coagulation because of their extensive surface area. This can compromise device functionality and lead to life-threatening complications. High doses of anticoagulants, combined with anti-thrombogenic surface coatings, are typically employed to mitigate this risk, but such treatment can lead to hemorrhagic complications.
View Article and Find Full Text PDFJ Artif Organs
January 2025
Department for Cardiac, Thoracic and Cardiovascular Surgery, University Hospital Regensburg, Regensburg, Germany.
Neutrophil extracellular traps (NETs) were detected in blood samples and in cellular deposits of oxygenator membranes during extracorporeal membrane oxygenation (ECMO) therapy and may be responsible for thrombogenesis. The aim was to evaluate the effect of the base material of gas fiber (GF, polymethylpentene) and heat exchange (HE) membranes and different antithrombogenic coatings on isolated granulocytes from healthy volunteers under static culture conditions. Contact of granulocytes with membranes from different ECMO oxygenators (with different surface coatings) and uncoated-GFs allowed detection of adherent cells and NETotic nuclear structures (normal, swollen, ruptured) using nuclear staining.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Surgery IV, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania.
In recent decades, the advantages of minimizing surgical trauma have led to the development of minimally invasive surgical procedures. While the benefits often outweigh the risks, several challenges are encountered that are not present in conventional surgical approaches. Unilateral pulmonary edema (UPE) after mitral interventions performed through a right-sided approach is a rare but potentially life-threatening event.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
January 2025
Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences - Guwahati, Guwahati, India.
Infect Drug Resist
December 2024
Department of Critical Care Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Purpose: With the development of extracorporeal membrane oxygenation (ECMO) technology, the duration of ECMO support has gradually increased, leading to an increased risk of ECMO-related bacterial resistance. Polymyxin B (PMB) is used to treat drug-resistant bacterial infections. However, the pharmacokinetic (PK) parameters of antibiotics may change during ECMO, resulting in over- or under-exposure.
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