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Review ArticleNarrative Review

Intravascular Gas Exchange: Physiology, Literature Review, and Current Efforts

Tobias L Straube, Stewart Farling, Marc A Deshusses, Bruce Klitzman, Ira M Cheifetz and Travis P Vesel
Respiratory Care April 2022, 67 (4) 480-493; DOI: https://doi.org/10.4187/respcare.09288
Tobias L Straube
Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
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  • For correspondence: [email protected]
Stewart Farling
Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina.
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Marc A Deshusses
Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina; and Duke Global Health Institute, Duke University, Durham, North Carolina.
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Bruce Klitzman
Kenan Plastic Surgery Research Labs, Duke University School of Medicine, Durham, North Carolina; and Department of Biomedical Engineering, Duke University, Durham, North Carolina.
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Ira M Cheifetz
Department of Pediatrics, Rainbow Babies and Children’s Hospital, Cleveland, Ohio.
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Travis P Vesel
Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
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Abstract

Acute respiratory failure with inadequate oxygenation and/or ventilation is a common reason for ICU admission in children and adults. Despite the morbidity and mortality associated with acute respiratory failure, few proven treatment options exist beyond invasive ventilation. Attempts to develop intravascular respiratory assist catheters capable of providing clinically important gas exchange have had limited success. Only one device, the IVOX catheter, was tested in human clinical trials before development was halted without FDA approval. Overcoming the technical challenges associated with providing safe and effective gas exchange within the confines of the intravascular space remains a daunting task for physicians and engineers. It requires a detailed understanding of the fundamentals of gas transport and respiratory physiology to optimize the design for a successful device. This article reviews the potential benefits of such respiratory assist catheters, considerations for device design, previous attempts at intravascular gas exchange, and the motivation for continued development efforts.

  • respiratory assist catheter
  • intravascular gas exchange
  • intravascular oxygenator
  • membrane oxygenation
  • respiratory failure
  • ARDS
  • hypoxemia

Footnotes

  • Correspondence: Tobias L Straube MD, Duke University Medical Center, 2301 Erwin Rd, Durham, NC 27710. E-mail: tobias.straube{at}duke.edu
  • Dr Straube is supported by NICHD of the National Institutes of Health under award number T32HD094671.

  • Drs Straube, Klitzman, Cheifetz, and Vesel have disclosed that they are listed as inventors on US patent application 15/950,517, Intravascular Membrane Oxygenator Catheter Systems and Methods. Drs Straube, Farling, Deshusses, Klitzman, Cheifetz, and Vesel have disclosed that they are listed as inventors on patent application 63/170,045, Intravascular Membrane Oxygenator Catheter.

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In this issue

Respiratory Care: 67 (4)
Respiratory Care
Vol. 67, Issue 4
1 Apr 2022
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Intravascular Gas Exchange: Physiology, Literature Review, and Current Efforts
Tobias L Straube, Stewart Farling, Marc A Deshusses, Bruce Klitzman, Ira M Cheifetz, Travis P Vesel
Respiratory Care Apr 2022, 67 (4) 480-493; DOI: 10.4187/respcare.09288

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Intravascular Gas Exchange: Physiology, Literature Review, and Current Efforts
Tobias L Straube, Stewart Farling, Marc A Deshusses, Bruce Klitzman, Ira M Cheifetz, Travis P Vesel
Respiratory Care Apr 2022, 67 (4) 480-493; DOI: 10.4187/respcare.09288
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  • Article
    • Abstract
    • Introduction
    • Description and Potential Benefits of Intravascular Gas Exchange Catheter
    • Considerations for Intravascular Respiratory Assist Catheter Design
    • Gas Exchange Requirements for a Respiratory Assist Catheter
    • Previous Respiratory Assist Catheters
    • Summary
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
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Keywords

  • respiratory assist catheter
  • intravascular gas exchange
  • intravascular oxygenator
  • membrane oxygenation
  • respiratory failure
  • ARDS
  • hypoxemia

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