Development of simulated and ovine models of extracorporeal life support to improve understanding of circuit-host interactions

Shekar, Kiran, Fung, Yoke L., Diab, Sara, Mullany, Daniel V., McDonald, Charles I, Dunster, Kimble R., Fisquet, Kimble R, Platts, David G., Stewart, David G, Wallis, Steven C., Smith, Maree T., Roberts, Jason A. and Fraser, John F. (2012) Development of simulated and ovine models of extracorporeal life support to improve understanding of circuit-host interactions. Critical Care and Resuscitation, 14 2: 105-111.

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Name Description MIMEType Size Downloads
Author Shekar, Kiran
Fung, Yoke L.
Diab, Sara
Mullany, Daniel V.
McDonald, Charles I
Dunster, Kimble R.
Fisquet, Kimble R
Platts, David G.
Stewart, David G
Wallis, Steven C.
Smith, Maree T.
Roberts, Jason A.
Fraser, John F.
Title Development of simulated and ovine models of extracorporeal life support to improve understanding of circuit-host interactions
Journal name Critical Care and Resuscitation   Check publisher's open access policy
ISSN 1441-2772
Publication date 2012-06-01
Sub-type Article (original research)
Volume 14
Issue 2
Start page 105
End page 111
Total pages 7
Place of publication Melbourne, Australia
Publisher Australasian Academy of Critical Care Medicine
Language eng
Formatted abstract
Background: Extracorporeal life support (ECLS) is a lifesaving technology that is being increasingly used in patients with severe cardiorespiratory failure. However, ECLS is not without risks. The biosynthetic interface between the patient and the circuit can significantly alter inflammation, coagulation, pharmacokinetics and disposition of trace elements. The relative contributions of the pump, disease and patient in propagating these alterations are difficult to quantify in critically ill patients with multiple organ failure.

Objective: To design a model where the relevance of individual components could be assessed, in isolation and in combination.

Design and subjects: Four ECLS models were developed and tested — an in-vitro simulated ECLS circuit; and ECLS in healthy sheep, sheep with acute lung injury (ALI), and sheep with ALI together with transfusion of old or new blood.

Main outcome measures: Successful design of in-vitro and in-vivo models.

Results: We successfully conducted multiple experiments in the simulated circuits and ECLS runs in healthy and ALI sheep. We obtained preliminary data on inflammation, coagulation, histology, pharmacokinetics and trace element
disposition during ECLS.

Conclusions: The establishment of in-vitro and in-vivo models provides a powerful means for enhancing knowledge of the pathophysiology associated with ECLS and identification of key factors likely to influence patient outcomes. A clearer description of the contribution of disease and therapeutic interventions may allow improved design of equipment, membranes, medicines and physiological goals for improved patient care.

Keyword Extracorporeal life support
Large animal-models
Membrane-oxygenation
Neutrophil activation
Gene-therapy
Sheep
Echocardiography
Hemodynamics
Ventilation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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