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

Matteo Di Nardo; Anthony Moreau; Filippo Annoni; Fuhong Su; Mirko Belliato; Lars Mikael Broman; Maximilian Malfertheiner; Roberto Lorusso; Fabio Silvio Taccone

doi:10.1177/02676591231202380

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

Perfusion. 2023 Sep 12:2676591231202380. doi: 10.1177/02676591231202380. Online ahead of print.

Authors

Matteo Di Nardo¹, Anthony Moreau^{2

3}, Filippo Annoni^{2

3}, Fuhong Su^{2

3}, Mirko Belliato⁴, Lars Mikael Broman^{5

6}, Maximilian Malfertheiner⁷, Roberto Lorusso⁸, Fabio Silvio Taccone^{2

3}

Affiliations

¹ Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
² Department of Intensive Care, Erasme Hospital, Brussels, Belgium.
³ Experimental Laboratory of Intensive Care, Universitè Libre de Bruxells, Brussels, Belgium.
⁴ SC AR2 Anestesia e Terapia Intensiva Cardiotoracica, Foundation IRCCS, Policlinico San Matteo, Pavia, Italy.
⁵ Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
⁶ ECMO Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden.
⁷ Internal Medicine II, University of Regensburg, Regensburg, Germany.
⁸ Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.

PMID: 37698935
DOI: 10.1177/02676591231202380

Abstract

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.

Keywords: centrifugal pump; extracorporeal membrane oxygenation; hemolysis; magnetical levitation; neonate; newborn.