Pediatric Artificial Lung: A Low-Resistance Pumpless Artificial Lung Alleviates an Acute Lamb Model of Increased Right Ventricle Afterload.

Journal Article (Journal Article)

Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload. Five juvenile lambs (20-30 kg) underwent PAL implantation in a pulmonary artery to left atrium configuration. Induction of disease involved temporary, reversible occlusion of the right main pulmonary artery. Hemodynamics, pulmonary vascular input impedance, and right ventricle efficiency were measured under 1) baseline, 2) disease, and 3) disease + PAL conditions. The disease model altered hemodynamics variables in a manner consistent with pulmonary hypertension. Subsequent PAL attachment improved pulmonary artery pressure (p = 0.018), cardiac output (p = 0.050), pulmonary vascular input impedance (Z.0 p = 0.028; Z.1 p = 0.058), and right ventricle efficiency (p = 0.001). The PAL averaged resistance of 2.3 ± 0.8 mm Hg/L/min and blood flow of 1.3 ± 0.6 L/min. This novel low-resistance PAL can alleviate pulmonary hypertension in an acute animal model and demonstrates potential for use as a bridge to lung recovery or transplantation in pediatric patients with significant pulmonary hypertension refractory to medical therapies.

Full Text

Duke Authors

Cited Authors

  • Alghanem, F; Bryner, BS; Jahangir, EM; Fernando, UP; Trahanas, JM; Hoffman, HR; Bartlett, RH; Rojas-Peña, A; Hirschl, RB

Published In

Volume / Issue

  • 63 / 2

Start / End Page

  • 223 - 228

PubMed ID

  • 27861431

Pubmed Central ID

  • PMC5325788

Electronic International Standard Serial Number (EISSN)

  • 1538-943X

Digital Object Identifier (DOI)

  • 10.1097/MAT.0000000000000481

Language

  • eng

Conference Location

  • United States