{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:30:37Z","timestamp":1760149837639,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:00:00Z","timestamp":1695513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Membranes"],"abstract":"<jats:p>Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy method for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients with such instances of refractory hypoxemia received a second membrane lung, either in series or in parallel, to overcome the hypoxemia. It remains unclear whether the parallel or serial connection is more effective. Therefore, we used an improved version of our full-flow ECMO mock circuit to test this. The measurements were performed under conditions in which the membrane lungs were unable to completely oxygenate the blood. As a result, only the photometric pre- and post-oxygenator saturations, blood flow and hemoglobin concentration were required for the calculation of oxygen transfer rates. The results showed that for a pre-oxygenator saturation of 45% and a total blood flow of 10 L\/min, the serial connection of two identical 5 L rated oxygenators is 17% more effective in terms of oxygen transfer than the parallel connection. Although the idea of using a second membrane lung if refractory hypoxia occurs is intriguing from a physiological point of view, due to the invasiveness of the solution, further investigations are needed before this should be used in a wider clinical setting.<\/jats:p>","DOI":"10.3390\/membranes13100809","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T04:15:38Z","timestamp":1695615338000},"page":"809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit"],"prefix":"10.3390","volume":"13","author":[{"given":"Albert J.","family":"Omlor","sequence":"first","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Caspari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonie S.","family":"Omlor","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Jungmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0113-0777","authenticated-orcid":false,"given":"Marcin","family":"Krawczyk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital of Saarland, 66424 Homburg, Germany"},{"name":"Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, 02091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Schmoll","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Mang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Seiler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf M.","family":"Muellenbach","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Campus Kassel of the University of Southampton, 34125 Kassel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Bals","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"},{"name":"Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), 66123 Saarbr\u00fccken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3620-0912","authenticated-orcid":false,"given":"Philipp M.","family":"Lepper","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V\u2014Pneumology, Allergology and Intensive Care Medicine, University Hospital of Saarland, 66424 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s13613-021-00897-3","article-title":"A Rational Approach on the Use of Extracorporeal Membrane Oxygenation in Severe Hypoxemia: Advanced Technology Is Not a Panacea","volume":"11","author":"Akoumianaki","year":"2021","journal-title":"Ann. 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