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Extracorporeal circulation (ECC) is frequently implemented in a vast array of modalities such as hemodialysis, cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO), and others. Patients receiving any such therapy are frequently encumbered with chronic inflammation, which is inherently accompanied by oxidative stress. However, ECC treatments themselves are also responsible for sustaining or promoting inflammation. On these grounds, an in vitro study was designed to investigate the therapeutic potential of molecular hydrogen (H2) against pro-inflammatory agents in ECC settings. Five miniature ECMO circuits and a small vial (Control) were primed with heparinized blood from healthy adult donors (n = 7). Three of the ECMO systems were injected with lipopolysaccharide (LPS), out of which one was additionally treated with an H2 gas mixture. After 6 h, samples were drawn for the assessment of specific biomarkers (MCP-1, MPO, MDA-a, TRX1, and IL-6). Preliminary results indicate a progressive oxidative and inflammatory response between the six systems. Circulation has triggered inflammation and blood trauma, but the staggering influence of LPS in this outcome is indisputable. Accordingly, hydrogen's remedial potential becomes immediately apparent as biomarker concentrations tend to be lower in the H2-handled circuit. Future research should have distinct objectives (e.g., dosage/duration/cycle of hydrogen administration) in order to ascertain the optimal protocol for patient treatment. [ABSTRACT FROM AUTHOR]

Membrane artificial lungs (oxygenators) are used in cardiopulmonary surgery as well as, in some cases, in severe lung disease to support the natural lung by means of ECMO (extracorporeal membrane oxygenation). The oxygen and carbon dioxide transfer rates of any oxygenator are usually assessed by considering several blood gas parameters, such as oxygen saturation, hemoglobin concentration, partial pressure of oxygen and carbon dioxide, bicarbonate concentration, and p H . Here, we report a set of semi-empirical equations that calculate such parameters directly from their partial pressures and assess the acid–base balance during ECMO. The implementation of this equation set permits the evaluation of any oxygenator, existing or prototypes in development, as well as the development of clinical decision-making tools for predicting the blood gas state and acid–base balance during surgical interventions and ECMO. The predicted results are then compared with experimental data obtained from in vitro gas exchange investigations with a commercial oxygenator using fresh porcine blood. The high correlation, R 2 > 0.95 , between the predicted and the experimental data suggests a possibility of using such empirical equations in the simulation of gas transfer in a cardiopulmonary system with an oxygenator for any venous inlet blood gas data and also for estimating the acid–base balance during such therapy. [ABSTRACT FROM AUTHOR]