An artificial oxygenation simulator aims to train surgeons for life and death situations
A patient is undergoing a major surgery and her condition is rapidly deteriorating due to failing lungs. All attempts to resuscitate have failed. Doctors decide to perform a rare and risky procedure called extra-corporeal membrane oxygenation (ECMO), a procedure that is often a matter of life and death, yet many have never practiced before.
Researchers at the Health Care Engineering Systems Center, a center supported by the Coordinated Science Lab and the College of Engineering, have developed an ECMO training simulator. Built to resemble the elasticity of arteries and pumped by an artificial heart, the simulator replicates the femoral artery leading to the heart that doctors need to operate on for the surgery.
The surgery’s purpose is to oxygenate the blood to provide temporary support to the heart and lung function in times of severe respiratory or cardiac failure.
“The simulator allows doctors to train for the surgery, which has never been possible before,” said Pramod Chembrammel, research scientist at HCESC. “They can practice placing a tube in the artery, identifying blood flow, and connecting the artery and blood supply to the external oxygenator.”
The team built the flexible vasculature using 3D printing and replicated the shape of the artery and blood flow within it based off a real femoral artery, providing an accurate training model.
The widespread adoption of ECMO has been limited by the unfamiliarity with how to safely and quickly do the surgery, including inserting the thin tube in the artery that provides the oxygen, a process called cannulation.
“In order for doctors to train inserting the tube to provide oxygen, the simulator had to have flexible human-like tissue, but manufacturing a flexible and hollow vasculature wasn’t possible, until now,” said Chembrammel.
The 3D printing method uses a water-soluble material coated with a silicone material that mimics tissue. Once the silicone coating cures, the model is immersed in warm water to dissolve the center water-soluble material, leaving a hollow artery that the artificial heart pumps fluid through.
The researchers, which include Chembrammel, Dr. Matthew Bramlet from OSF Healthcare and Jump ARCHES, Dr. Jai Raman from Oregon Health & Science University and HCESC affiliate, University of Illinois students Shashwat Gupta and Mark Doose, and CSL and ISE Professor and HCESC Director Kesh Kesavadas, are also working on creating a pigment in the blood simulant that will change colors to simulate oxygenation, indicating the surgery has been effective.
“ECMO is initiated in crash-and-burn situations and this technology will help replicate these difficult scenarios, which we hope will result in safer and more effective procedures by giving doctors the opportunity to practice it before they need to perform the surgery,” said Chembrammel.
The simulator will be tested by surgeons at OSF Saint Francis Medical Center in Peoria and Oregon Health & Science University. When successfully developed, the simulator will become a part of the curriculum of residency programs in order to equip future physicians for these situations.
This project was funded by Jump ARCHES. Researchers presented this work at the IEEE Engineering in Medicine & Biology Society (EMBS) conference in Jeju, South Korea.