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Biomedical Engineers Design a Vision for the Future

Thirty eight years since the first artificial heart was implanted in 61-year old dentist Barney Clark to replace his failing heart, the world has seen huge advances in mechanical circulatory support science. Devices are now capable of augmenting the circulation of the native heart to give the damaged organ a chance to heal and recover, or as a bridge to transplant. Biomedical engineers have their hands in other developmental miracles such as replacement heart valves, now deployed by intravascular catheters, miniature heart pumps suitable for children and replacement vessels of tissue engineered from cells seeded on biocompatible scaffolds. The dreams each new generation brings to the field of biomedical engineering has propelled us into evermore possibilities built on medical science and compassion. Transonic is proud to be part of that past and future vision.

Did you know that much of the groundwork and testing of Ventricular Assist Devices (VADs) was accomplished and measured using Transonic tubing Flowsensors? Models of the circulatory system are fabricated from flexible tubing conduits, pumps, valves and clamps in the R&D lab to challenge and test these devices under various conditions using blood and blood “analog” substitutes to ensure their efficacy and longevity for implant. From design, to test, to manufacture and ultimately to clinical use, Transonic, the inventor of non-invasive volume flow sensors for tubing, has had a hand in the history and progress of all these devices:

Thoratec’s Heartmate (now Abbott Labs)
Micromed’s DeBakey Heart Assist 5
TandemHeart pVAD (now LivaNova)

Likewise, Transonic tubing Flowsensors are used in the development of other circulatory support devices that have become the standard of care for transplant organ perfusion, CP bypass, ECMO and hemodialysis. What other applications and devices can we imagine that will become the future of medical care relying on accurate, real time flow measurement? Here are some visions that could become the future!

Liquid Ventilators & ECMO that deliver oxygen in severely compromised lung function for Acute Respiratory Distress Syndrome (ARDS)

Many remember the awe inspiring scene in The Abyss where a rat is able to breathe in a liquid environment. This is a reference to real oxygen carrying perfluorocarbon (PFC) liquid which does have medical use and as early as the 1990’s was being considered as an alternative method of ventilating of patients with severe ARDS by providing a higher level of oxygen to the lungs with liquid rather than by forced gas ventilation. Transonic clamp-on tubing Flowsensors were successful in measuring flow delivery of this novel PFC liquid even though its very high specific gravity slowed the acoustic signal almost off scale and specialized calibration processes were required. Transonic’s willingness to find custom solutions for novel experimental problems makes Transonic a responsive partner for this kind of innovative research.

This research into liquid ventilation and pivotal studies to develop ECMO (Extracorporeal Membrane Oxygenation) treatments were performed at the Univ. of Michigan, Ann Arbor in the research laboratory of Dr. Robert Bartlett, Dr. Ronald Hirschl and others. Once considered an experimental treatment only for critically ill babies, ECMO systems provide heart-lung bypass life support to oxygenate the blood outside of the body via bypass pumps. This treatment, now also applied in critically ill adult patients, relies on the continuous flow of the patient’s blood pumped through the bypass tubing over a period of days to weeks. Transonic clamp-on Flowsensors ensure the flow rate is adequate and life sustaining. Transonic was the first to provide external, non-invasive clamp-on Flowsensors for these ECMO tubing blood lines. From bench to bedside, Transonic flow measurement sensors ensure the robust design and high performance of these and many other biomedical devices.

Mechanical Organ Substitutes to Artificial Implantable Organs

In an effort to create a more physiological approach to support premature infants born before 28 weeks, researchers at Children’s Hospital of Philadelphia (CHOP) created an extra-uterine womb.

Researchers delivered premature lambs and placed them into a sterile bag filled with electrolyte fluid, and implanted tubes carrying oxygenated blood into the lamb’s umbilical cord. This allowed for the lamb’s heart to pump blood comparable to what a placenta would provide.

According to the report published in Nature Communications, “Connections were established as an arterial-venous extracorporeal oxygenation circuit, with the carotid artery or umbilical arteries providing inflow to the oxygenator (CA/JV or UA/UV) connected to the oxygenator inflow port and the jugular vein or umbilical vein (CA/JV or UA/UV) providing outflow from the oxygenator and connected to the oxygenator outflow port.”

Researchers used Transonic’s HXL Tubing Flowsensor to continuously measure circuit flow. Researchers also used the Transonic HXL Tubing Flowsensor to monitor the level of fluid volume in the artificial amniotic sac.

Additional References:
Mechanical Organ Substitutes to Artificial Implantable Organs

Study
Lung Management with Perfluorocarbon Liquid Ventilation Improves Pulmonary Function and Gas Exchange During Extracorporeal Membrane Oxygenation (ECMO)
Read more 
Study
Development and application of a simplified liquid ventilator
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Article
Alliance stock plummets as LiquiVent disappoints in ARDS trial
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Study
Liquid Ventilation
Read more 
Study
Partial Liquid Ventilation in Critically Ill Infants Receiving Extracorporeal Life Support
Read more 
Study
Assessing the impacts of total liquid ventilation on left ventricular diastolic function in a model of neonatal respiratory distress syndrome
Read more 
Article
Liquid breathing moves a step closer thanks to measurement study
Read more 
Study
Total liquid ventilation: dynamic airway pressure and the development of expiratory flow limitation
Read more 
Artificial Organs & Organ Preservation
Profile
Jutta Arens,
Helmholtz Institute
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