Patient Care Technologies for Permanent Ambulatory Artificial Lung Support
Abstract
Overall Program The goal of this project is to develop the technologies necessary to support Veterans with long-term, incurable lung disease for a period of months to years at home using a pulmonary assist system (PAS). Over 16 million patients in the U.S. suffer from incurable lung disease. The function of these patients’ lungs declines gradually over time, and these patients also experience recurring, temporary periods with a severe loss in lung function. These periods typically follow a lung infection or breathing in harmful matter. Veterans are 1.5 to 3 times more likely than the general population to develop these long-term lung diseases, and they are the fourth most prevalent disease in the Department of Veterans Affairs (VA) patient population. Treating these diseases resulted in approximately $5.2 billion of annual VA spending as of 2008. The only treatment for these patients that restores their health is lung transplantation, but less than 2,800 donor lungs are available in the U.S. each year. Our goal, therefore, is to develop a portable means of respiratory support that provides years of safe, home-based respiratory support for Veterans with incurable lung disease. To accomplish this, we have developed a PAS that consists of a small artificial lung coupled with a small pump that is designed for permanent use. The full PAS is small, lightweight (2.3 kg) and can be run on battery power, enabling highly mobile support. Patients suffering a temporary loss in lung function would have a PAS attached within the hospital, providing mobile respiratory support and simplifying their care. Patients who keep returning to the hospital like this would be maintained on the system and transitioned to home-based care. Every 2-3 months, the patient would return to the hospital for scheduled PAS artificial lung replacement. The PAS system would improve patient mobility, reduce the chances they return to the hospital, improve quality of life, and increase survival. PAS support on a regular hospital floor, in a nursing facility, or at the patient’s home will require development of new procedures and technologies. First, the current intravenous (IV) method of stopping blood clotting in artificial lungs will not be safe in these settings because it causes dangerous clotting in the artificial lung if too little is given or bleeding in the patient if too much is given. Project 1 will first develop a means to stop blood clotting in artificial lungs with minimal oral medication plus a coating on the artificial lung that slow clot formation without causing patient bleeding. These medications are currently being used for other applications and could be used quickly to help patients on the PAS. Project 2 then develops an even safer method of slowing blood clotting for home-based therapy. This medication, FXII900-PCB, slows blood clotting only in artificial medical devices, not in the patient. Thus, it should be highly safe. However, it will take longer to reach the clinic, as it requires more testing. Project 3 will ensure that the way the PAS system is attached to the patient is sufficiently durable for home-based support. The PAS will be attached using specialized tubes that can be sewn onto the heart. These tubes then come out through the skin, and are treated with silver, which reduces the risk of infection. Project 3 will prototype and test different attachment methods to optimize durability, ease of deployment, and PAS support. Despite these advances, the PAS function will deteriorate over time. Therefore, a lightweight, unobtrusive means of remotely monitoring PAS function will be developed in Project 4. This system will transmit key variables describing the function of the PAS, such as blood flow and oxygen transfer. In doing so, it provides early warning if PAS function is deteriorating. The patient can then schedule device repair or replacement prior to significant performance deterioration. These technologies will enable
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210304
Entities
People
- Keith Cook
Organizations
- Carnegie Mellon University
- United States Army