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This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 

 

 

 

 

 

 
 

 

 

 

Pre-clinical Evaluation of an Adult 

Extracoproreal Carbon Dioxide 

Removal System for Pediatric 

Application 

Yerbol Mussin1, Richard Jeffries2, 

Denis Bulanin1, Zhaksybay 

Zhumadilov1, Farkhad Olzhayev1, 

William Federspiel2 
 
1Center for Life Sciences, Nazarbayev 
University, Astana, Kazakhstan; 
2McGowan Insitute for Regenerative 
Medicine, Pittsburgh, USA 

 

 

 

 

 

 

 

 

 

 

 

Vol. 3, Suppl. (2014)   |   ISSN 2166-7403 (online)    

DOI 10.5195/cajgh.2014.167   |   http://cajgh.pitt.edu 

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MUSSIN 

 

 

This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 

This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 

Central Asian Journal of Global Health 

Volume 3, Suppl. (2014)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2014.167  |  http://cajgh.pitt.edu 

  

 

Abstract 

Introduction. Adult extracorporeal carbon dioxide removal (ECCO2R) systems and pediatric ECMO share the common objectives 

of having a low blood flow rate and low priming volume while safely maintaining sufficient respiratory support. The Hemolung is 

a highly simplified adult ECCO2R system intended for partial respiratory support in adult patients with acute hypercapnic 

respiratory failure. The objective of this work was to conduct pre-clinical feasibility studies to determine if a highly efficient, active-

mixing, adult ECCO2R system can safely be translated to the pediatric population.   

Methods. 14 healthy nonsedated juvenile sheep were used for acute (2 animals) and 7-day chronic (12 animals) in-vivo studies to 

evaluate treatment safety independently of respiratory related injuries. In all evaluations, we hypothesized that gas exchange 

capabilities of the Hemolung RAS in this model would be equivalent to the adult configuration performance at similar blood flows 

- minimum CO2 removal of 50 mL/min at a venous partial pressure of CO2 equal to 45 mmHg. Target blood flow rates were set 

to a minimum of 280 mL/min. Swan Ganz catheters were used under general anesthesia in the two acute subjects to evaluate blood 

gas status in the pulmonary artery. 

Results. The Hemolung RAS was found to have adequate gas exchange and pumping capabilities for full respiratory support for 

subjects weighing 3 – 25 kg. The Hemolung device was estimated to provide a partial respiratory support for subjects weighing 27 

– 34 kg. The seven-day studies in juvenile sheep demonstrated that veno-venous extracorporeal support could be provided safely 

at low flows with no significant adverse reactions related to device operation. 

Conclusion. The study outcomes suggest the potential use of the Hemolung RAS in a veno-venous pediatric configuration to safely 

provide respiratory support utilizing a significantly less complex system than traditional pediatric ECMO. 

Keywords: Hemolung, extracorporeal carbon dioxide removal, pediatric ECMO, respiratory support 

 

 

 

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