Development of a modular device for extracorporeal life support in multiorgan failure patients

The research program consists in the development of a modular device for extracorporeal life support.

The device provides a main branch for Extracorporeal Carbon Dioxide Removal (ECCO2R) intended to be used in patients suffering from Chronic Obstructive Pulmonary Disease (COPD) or mild to moderate acute respiratory distress syndrome (ARDS), for the reduction of respiratory hypercapnia/acidosis due to ultra-protective mechanical ventilation.
In addition, the device can provide Continuous Renal Replacement Therapy (CRRT) through a dedicated hemofiltration line, which can be connected in parallel to ECCO2R line at the user’s request without treatment interruption. The combination of ECCO2R with CRRT may offer multiple advantages to manage respiratory acidosis in patients with ARDS developing renal dysfunctions.

The CRRT line is composed of an ultrafiltration line and a replacement line in post-dilution, which can be enabled or not to perform isolated ultrafiltration (slow continuous ultrafiltration, SCUF) or hemofiltration (Ultrafiltration + replacement fluid infusion) according to the patient’s need. The hemofiltration line presents an innovative pump-free system for ultrafiltration rate regulation, as an alternative to state-of-the-art solutions with peristaltic pump.

The method consists of a motorized pinch valve on the ultrafiltration line, whose intermittent opening defines the ultrafiltration rate. The clamp opening is modulated with a closed-loop control system based on the real-time monitoring of the ultrafiltrate collected and replacement fluid infused, through weight scales.

In critically ill ARSD patients undergoing ECCO2R, serial or parallel hemoperfusion treatment may be used to remove inflammatory mediators released due to respiratory dysfunction and thus prevent the cascade of events leading to multiorgan dysfunction. For this reason, feasibility studies are currently ongoing for the integration of an hemoperfusion (HP) line, with the aim of developing a customizable platform for extracorporeal multi-organ support