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Extracorporeal membrane oxygenation device is a procedure in which mechanical systems circulate blood and supply oxygen to patients with impaired cardiopulmonary function. Current venoarterial systems are associated with low patient survival rates and new treatments are needed to avoid left ventricular dilation, which is a major cause of death. In this study, a new mobile pulsatile ECMO with a pump structure that supplies pulsatile flow by using an oxygen tank as a power source is proposed. In vitro experiments conducted under mock circulation system as like patient conditions demonstrated that 2.8 L oxygen can sustain the outflow of 1 L/min of pulsatile blood flow for 53 min, while a 4.6 L tank was able to sustain the same flow for 85 min. The energy equivalent pressure evaluation index of the pulsatile blood pump shows that the mobile pulsatile ECMO could supply sufficient pulsatile blood flow compared to the existing pulsatile ECMO. Through in vitro experiments performed under mock circulation conditions, this new system was proven to supply sufficient oxygen and pulsatile blood flow using the pressure of an oxygen tank even while transporting a patient.
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http://dx.doi.org/10.1007/s13534-023-00295-7 | DOI Listing |
Gen Thorac Cardiovasc Surg
July 2025
Department of Cardiovascular Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Objectives: ECPELLA, which uses veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and the Impella percutaneous ventricular assist device, is effective for patients with cardiogenic shock. However, patients with severe right heart dysfunction frequently have difficulty weaning off V-A ECMO. Inhaled nitric oxide (iNO) therapy may induce pulmonary artery pressure while improving right ventricular function.
View Article and Find Full Text PDFShock
September 2025
Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Von Willebrand factor (vWF) orchestrates hemostasis through platelet activation, factor VIII stabilization, and inflammatory modulation, with emerging evidence highlighting its shear-dependent conformational dynamics as a critical regulator of thrombus formation. The protease ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13) cleaves ultralarge vWF multimers under physiological conditions, although its efficiency declines sharply at supraphysiological shear forces characteristic of extracorporeal membrane oxygenation (ECMO) circuits. Beyond proteolytic regulation, cumulative evidence confirms that vWF self-association, autoregulatory domains, and inflammatory mediators collectively modulate vWF's thrombogenic potential during ECMO support.
View Article and Find Full Text PDFBiomed Eng Online
July 2025
Department of Smart Health Science and Technology, Kangwon National University, Chuncheon-Si, 24341, Korea.
Implementing counter-pulsation (CP) control in pulsatile extracorporeal membrane oxygenator (p-ECMO) systems offers a refined approach to mitigate risks commonly associated with conventional ECMOs. To attain CP between the p-ECMO and heart, accurate detection of heartbeats within blood pressure (BP) waveform data becomes imperative, especially in situations where measuring electrocardiograms (ECGs) are difficult or impractical. In this study, a cumulative algorithm incorporating filter-type neural networks was developed to distinguish heartbeats from other pulse signals generated by the p-ECMO, reflections, or motion artifacts in the BP data.
View Article and Find Full Text PDFArtif Organs
July 2025
Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Purpose: To build a mock circulatory loop to simulate veno-arterial extracorporeal membrane oxygenation (V-A ECMO) haemodynamics using a patient-specific silicone aortic phantom and compare the flow dynamics for continuous and pulsatile ECMO settings.
Methods: A silicone model of a human aorta with major branches was fabricated and the left iliac artery was cannulated using a Xenios ECMO device to simulate a peripheral V-A ECMO configuration. The left ventricular outflows at the aortic root were simulated using a piston pump.
Resusc Plus
September 2025
Division of Cardiac Surgery, Cardiovascular Surgical Intensive Care, Department of Surgery, Heart and Vascular Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising intervention for refractory cardiac arrest, with potential benefits in survival and neurological outcomes. However, the impact of ECPR's rapid, non-pulsatile restoration of cerebral blood flow on intracranial physiology and autoregulation remains poorly understood.
Methods: Using a porcine model, this study investigated the dynamics of intracranial pressure (ICP), cerebral autoregulation, and pulsatility during key experimental phases: Baseline, Fibrillation, ECMO, and ROSC.