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Evaluation of a new magnetically suspended centrifugal neonatal pump in healthy animals using a veno-venous extracorporeal membrane oxygenation configuration

par Di Nardo, Matteo;Moreau, Anthony ;Annoni, Filippo ;Su, FUHONG ;Belliato, Mirko;Broman, Lars Mikael;Malfertheiner, Maximilian;Lorusso, Roberto;Taccone, Fabio
Référence Perfusion
Publication Publié, 2023

Article révisé par les pairs

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Résumé :

Background: The objective of this animal study was to evaluate the hemodynamic performance of a new centrifugal pump for extra-corporeal membrane oxygenation (ECMO) support in neonates. Methods: Six healthy swines were supported with veno-venous ECMO with the New Born ECMOLife centrifugal pump (Eurosets, Medolla, Italy) at different flow rates: 0.25, 0.5, 0.6, and 0.8 L/min; three animals were evaluated at low-flows (0.25 and 0.5 L/min) and three at high-flows (0.6 and 0.8 L/min). Each flow was maintained for 4 hours. Blood samples were collected at different time-points. Hematological and biochemical parameters and ECMO parameters [flow, revolutions per minute (RPM), drainage pressure, and the oxygenator pressure drop] were evaluated. Results: The increase of the pump flow from 0.25 to 0.5 L/min or from 0.6 to 0.8 L/min required significantly higher RPM and produced significantly higher pump pressures [from 0.25 to 0.5 L/min: 1470 (1253–1569) versus 2652 (2589–2750) RPM and 40 (26–57) versus 125 (113–139) mmHg, respectively; p <.0001 for both - from 0.60 to 0.8 L/min: 1950 (1901–2271) versus 2428 (2400–2518) RPM and 66 (62–86) versus 106 (101–113) mmHg, respectively; p <.0001 for both]. Median drainage pressure significantly decreased from −18 (−22; −16) mmHg to −55 (−63; −48) mmHg when the pump flow was increased from 0.25 to 0.5 L/min (p <.0001). When pump flow increased from 0.6 to 0.8 L/min, drainage pressure decreased from −32 (−39; −24) mmHg to −50 (−52; −43) mmHg, (p <.0001). Compared to pre-ECMO values, the median levels of lactate dehydrogenase, d-dimer, hematocrit, and platelet count decreased after ECMO start at all flow rates, probably due to hemodilution. Plasma-free hemoglobin, instead, showed a modest increase compared to pre-ECMO values during all experiments at different pump flow rates. However, these changes were not clinically relevant. Conclusions: In this animal study, the “New Born ECMOLife” centrifugal pump showed good hemodynamic performance. Long-term studies are needed to evaluate biocompatibility of this new ECMO pump.