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#34520832   2021/09/11 To Up

Pharmacokinetics of fluconazole and ganciclovir as combination antimicrobial chemotherapy on ECMO- A case report.

ECMO can affect antimicrobial pharmacokinetics. We describe a case of a 33-year-old male, 60 kg, with newly diagnosed AIDS presenting in acute severe type 1 respiratory failure. Positive cultures for Candida albicans from respiratory specimens and high blood cytomegalovirus titers. The patient required veno-venous ECMO therapy for the refractory respiratory failure. Intravenous fluconazole (6 mg/kg, 24- hourly) and ganciclovir (5 mg/kg, 12- hourly) was commenced. Pre-oxygenator, post-oxygenator and arterial blood samples were collected post antibiotic administration and were analyzed for total fluconazole and ganciclovir concentrations. Although there was a 41% increase in the volume of distribution for fluconazole relative to healthy volunteers, the pharmacodynamic targets for prophylaxis were still met. The area under the curve exposure of ganciclovir (50.78 mg•h/L) achieved target thresholds. The ECMO circuit had no appreciable effect on achievement of therapeutic exposures of fluconazole and ganciclovir.
Jayesh A Dhanani, Jeffrey Lipman, Jason Pincus, Shane Townsend, Amelia Livermore, Steven C Wallis, Mohd H Abdul-Aziz, Jason A Roberts

2640 related Products with: Pharmacokinetics of fluconazole and ganciclovir as combination antimicrobial chemotherapy on ECMO- A case report.



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#34519067   2021/09/14 To Up

Veno-Arteriovenous Extracorporeal Membrane Oxygenation - A Single Center Experience.

Patients with combined circulatory shock and respiratory failure may benefit from veno-arteriovenous (V-AV) extracorporeal membrane oxygenation support (ECMO). We report our center's experience with V-AV ECMO and propose an algorithm to help identify patients that may benefit from early V-AV ECMO support.
Mircea R Mihu, Dennis Mageka, Laura V Swant, Ahmed El Banayosy, Marc O Maybauer, Michael D Harper, Michael M Koerner, Aly El Banayosy

2793 related Products with: Veno-Arteriovenous Extracorporeal Membrane Oxygenation - A Single Center Experience.

2 Pieces/Box0.1 ml 6 ml Ready-to-use 1ml4 Membranes/Box2 Membrane supply4 Membranes/Box2 Membrane supply4 Membranes/Box2 Membrane supply4 Membranes/Box100μg

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#34511780   2021/08/19 To Up

Reuse policy done and dusted.

As cardiac surgery was developing, a lot of innovations and compromises were required. Reusable disc oxygenator was used; at a point in time, a single oxygenator was used for two patients with the same blood group. Tubings were re-sterilised with formalin tablets and reused. This led to a surge in infections and therefore reuse was given up and effective infection control practices introduced.
Muralidharan Srinivasan

1694 related Products with: Reuse policy done and dusted.

25 mg2.5 mg10 mg100ug500 mg25 mg 5 G50 ug 5 G100ul1 g96 wells (1 kit)

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#34510993   2021/09/11 To Up

Risk factors and treatment of oxygenator high-pressure excursions during cardiopulmonary bypass.

A high-pressure excursion (HPE) is a sudden increase in oxygenator inlet pressure during cardiopulmonary bypass (CPB). The aims of this study were to identify factors associated with HPE, to describe a treatment protocol utilizing epoprostenol in severe cases, and to assess early outcome in HPE patients.
Anders Karl Hjärpe, Anders Jeppsson, Lukas Lannemyr, Martin Lindgren

2314 related Products with: Risk factors and treatment of oxygenator high-pressure excursions during cardiopulmonary bypass.

255x96 well plate100ug5mg1 6 ml Ready-to-use 400Tests100 mg96 wells (1 kit)

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#34480376   2021/09/03 To Up

Evaluation of umbilical venous flow volume measured using ultrasound compared to circuit flow volume in the EXTra-uterine Environment for Neonatal Development (EXTEND) system in fetal sheep.

To compare and validate umbilical venous flow volume (UVFV) measured at the intra-abdominal portion using ultrasound with actual flow volume of umbilical vein (UV) in fetal sheep sustained on the EXTrauterine Environment for Neonatal Development (EXTEND) system.
Katsusuke Ozawa, Marcus G Davey, Zhiyun Tian, Matthew A Hornick, Ali Y Mejaddam, Patrick E McGovern, Alan W Flake, Jack Rychik

1121 related Products with: Evaluation of umbilical venous flow volume measured using ultrasound compared to circuit flow volume in the EXTra-uterine Environment for Neonatal Development (EXTEND) system in fetal sheep.

100ug Lyophilized1 kit100ug Lyophilized

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#34442603   2021/08/19 To Up

Towards Biohybrid Lung: Induced Pluripotent Stem Cell Derived Endothelial Cells as Clinically Relevant Cell Source for Biologization.

In order to provide an alternative treatment option to lung transplantation for patients with end-stage lung disease, we aim for the development of an implantable biohybrid lung (BHL), based on hollow fiber membrane (HFM) technology used in extracorporeal membrane oxygenators. Complete hemocompatibility of all blood contacting surfaces is crucial for long-lasting BHL durability and can be achieved by their endothelialization. Autologous endothelial cells (ECs) would be the ideal cell source, but their limited proliferation potential excludes them for this purpose. As induced pluripotent stem cell-derived ECs enable the generation of a large number of ECs, we assessed and compared their capacity to form a viable and confluent monolayer on HFM, while indicating physiologic EC-specific anti-thrombogenic and anti-inflammatory properties. ECs were generated from three different human iPSC lines, and seeded onto fibronectin-coated poly-4-methyl-1-pentene (PMP) HFM. Following phenotypical characterization, ECs were analyzed for their thrombogenic and inflammatory behavior with or without TNFα induction, using FACS and qRT-PCR. Complementary, leukocyte- and platelet adhesion assays were carried out. The capacity of the iPSC-ECs to reendothelialize cell-free monolayer areas was assessed in a scratch assay. ECs sourced from umbilical cord blood (hCBECs) were used as control. iPSC-derived ECs formed confluent monolayers on the HFM and showed the typical EC-phenotype by expression of VE-cadherin and collagen-IV. A low protein and gene expression level of E-selectin and tissue factor was detected for all iPSC-ECs and the hCBECs, while a strong upregulation of these markers was noted upon stimulation with TNFα. This was in line with the physiological and strong induction of leukocyte adhesion detected after treatment with TNFα, iPSC-EC and hCBEC monolayers were capable of reducing thrombocyte adhesion and repopulating scratched areas. iPSCs offer the possibility to provide patient-specific ECs in abundant numbers needed to cover all blood contacting surfaces of the BHL with a viable, non-thrombogenic and non-inflammatory monolayer. iPSC-EC clones can differ in terms of their reendothelialization rate, and pro-inflammatory response. However, a less profound inflammatory response may even be advantageous for BHL application. With the proven ability of the seeded iPSC-ECs to reduce thrombocyte adhesion, we expect that thrombotic events that could lead to BHL occlusion can be avoided, and thus, justifies further studies on enabling BHL long-term application.
Michael Pflaum, Julia Dahlmann, Lena Engels, Hossein Naghilouy-Hidaji, Denise Adam, Janina Zöllner, Annette Otto, Sabrina Schmeckebier, Ulrich Martin, Axel Haverich, Ruth Olmer, Bettina Wiegmann

2032 related Products with: Towards Biohybrid Lung: Induced Pluripotent Stem Cell Derived Endothelial Cells as Clinically Relevant Cell Source for Biologization.

0.5 ml1.00 flask1.00 flask1.00 flask1.00 flask1.00 flask1 x 10^6 cells/vial1.00 flask96 tests1.00 flask

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#34442512   2021/07/28 To Up

Toward Development of a Higher Flow Rate Hemocompatible Biomimetic Microfluidic Blood Oxygenator.

The recent emergence of microfluidic extracorporeal lung support technologies presents an opportunity to achieve high gas transfer efficiency and improved hemocompatibility relative to the current standard of care in extracorporeal membrane oxygenation (ECMO). However, a critical challenge in the field is the ability to scale these devices to clinically relevant blood flow rates, in part because the typically very low blood flow in a single layer of a microfluidic oxygenator device requires stacking of a logistically challenging number of layers. We have developed biomimetic microfluidic oxygenators for the past decade and report here on the development of a high-flow (30 mL/min) single-layer prototype, scalable to larger structures via stacking and assembly with blood distribution manifolds. Microfluidic oxygenators were designed with biomimetic in-layer blood distribution manifolds and arrays of parallel transfer channels, and were fabricated using high precision machined durable metal master molds and microreplication with silicone films, resulting in large area gas transfer devices. Oxygen transfer was evaluated by flowing 100% O at 100 mL/min and blood at 0-30 mL/min while monitoring increases in O partial pressures in the blood. This design resulted in an oxygen saturation increase from 65% to 95% at 20 mL/min and operation up to 30 mL/min in multiple devices, the highest value yet recorded in a single layer microfluidic device. In addition to evaluation of the device for blood oxygenation, a 6-h in vitro hemocompatibility test was conducted on devices ( = 5) at a 25 mL/min blood flow rate with heparinized swine donor blood against control circuits ( = 3). Initial hemocompatibility results indicate that this technology has the potential to benefit future applications in extracorporeal lung support technologies for acute lung injury.
Jose Santos, Else M Vedula, Weixuan Lai, Brett C Isenberg, Diana J Lewis, Dan Lang, David Sutherland, Teryn R Roberts, George T Harea, Christian Wells, Bryan Teece, Paramesh Karandikar, Joseph Urban, Thomas Risoleo, Alla Gimbel, Derek Solt, Sahar Leazer, Kevin K Chung, Sivaprasad Sukavaneshvar, Andriy I Batchinsky, Jeffrey T Borenstein

2924 related Products with: Toward Development of a Higher Flow Rate Hemocompatible Biomimetic Microfluidic Blood Oxygenator.

100 UG1100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized100ug Lyophilized

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#34436868   2021/08/26 To Up

Anti-thrombogenic Surface Coatings for Extracorporeal Membrane Oxygenation: A Narrative Review.

Extracorporeal membrane oxygenation (ECMO) is used in critical care to manage patients with severe respiratory and cardiac failure. ECMO brings blood from a critically ill patient into contact with a non-endothelialized circuit which can cause clotting and bleeding simultaneously in this population. Continuous systemic anticoagulation is needed during ECMO. The membrane oxygenator, which is a critical component of the extracorporeal circuit, is prone to significant thrombus formation due to its large surface area and areas of low, turbulent, and stagnant flow. Various surface coatings, including but not limited to heparin, albumin, poly(ethylene glycol), phosphorylcholine, and poly(2-methoxyethyl acrylate), have been developed to reduce thrombus formation during ECMO. The present work provides an up-to-date overview of anti-thrombogenic surface coatings for ECMO, including both commercial coatings and those under development. The focus is placed on the coatings being developed for oxygenators. Overall, zwitterionic polymer coatings, nitric oxide (NO)-releasing coatings, and lubricant-infused coatings have attracted more attention than other coatings and showed some improvement in and anti-thrombogenic effects. However, most studies lacked standard hemocompatibility assessment and comparison studies with current clinically used coatings, either heparin coatings or nonheparin coatings. Moreover, this review identifies that further investigation on the thrombo-resistance, stability and durability of coatings under rated flow conditions and the effects of coatings on the function of oxygenators (pressure drop and gas transfer) are needed. Therefore, extensive further development is required before these new coatings can be used in the clinic.
Meili Zhang, Jo P Pauls, Nicole Bartnikowski, Andrew B Haymet, Chris H H Chan, Jacky Y Suen, Bailey Schneider, Katrina K Ki, Andrew K Whittaker, Matthew S Dargusch, John F Fraser

1453 related Products with: Anti-thrombogenic Surface Coatings for Extracorporeal Membrane Oxygenation: A Narrative Review.

2 Membrane supply100μg100μg2 Membrane supply1 mL100μg2 Membrane supply100 µg100 TESTS2 Membrane supply25 µg1 ml

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#34415712   2021/06/24 To Up

Sequestration of Midazolam, Fentanyl, and Morphine by an Ex Vivo Cardiopulmonary Bypass Circuit.

Cardiopulmonary bypass (CPB) circuits can significantly sequester intravenous anesthetics. Adsorption of medications by our institution's standard circuit (Terumo CAPIOX FX05 oxygenator; noncoated polyvinylchloride tubing) has not been described. We prepared ex vivo CPB circuits with and without oxygenators. Medication combinations studied included midazolam (0.5 mg), fentanyl (50 [micro]g), midazolam (0.5 mg) with morphine (0.5 mg), and midazolam (0.5 mg) with fentanyl (50 [micro]g). Medications were administered after obtaining baseline samples. Samples were drawn at 2, 5, 15, 30, 60, 120, and 180 minutes, and analyzed for concentration of injected medications. Midazolam demonstrated no sequestration after 180 minutes. Fentanyl concentration at 180 minutes was lower with an oxygenator (52.7 +/- 12.5 vs. 110.9 +/- 12.0 ng/ml, P = 0.00432). More fentanyl was found in solution after 180 minutes when given with midazolam compared to fentanyl given alone in the presence of an oxygenator (101 +/- 22.3 vs. 52.7 +/- 12.5 ng/ml, P = 0.044). Less midazolam was present after 180 minutes when given with morphine compared to midazolam given alone in the absence of an oxygenator (1264.9 +/- 425.6 vs. 2124 +/- 254 ng/ml, P = 0.037). We successfully characterized the adsorption of various combinations of midazolam, fentanyl, and morphine to our CPB circuit, showing that fentanyl and midazolam behave differently based on other medications present.
Michael T Kuntz, Luis M Pereira, Gregory S Matte, Kevin Connor, Steven J Staffa, James A DiNardo, Viviane G Nasr

2529 related Products with: Sequestration of Midazolam, Fentanyl, and Morphine by an Ex Vivo Cardiopulmonary Bypass Circuit.

1 mg100ug1 mg100ug200 100ug100 1,000 tests100ug100ug50μl

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