Project Description:
Acute conditions such as sepsis, crush injuries, and poisonings can lead to the accumulation of harmful, non-dialyzable toxins in the bloodstream. Current clinical practice addresses this limitation by using hemodialysis in tandem with Extracorporeal Membrane Oxygenation (ECMO), enabling simultaneous life support and enhanced toxin transport. However, this approach is constrained by a significant mismatch in flow rates, as ECMO operates at 4-5 L/min, while dialysis systems function at 0.1-0.5 L/min. To address this critical gap, we developed a high-flow hemofiltration system that integrates ECMO and dialysis into a single platform, enabling improved toxin clearance while maintaining hemodynamic stability. Our prototype introduces a secondary recirculation loop that processes effluent from the hemodialysis filter through a custom adsorption column. This column contains an ion-exchange resin designed to selectively bind toxins, enabling their removal from the effluent, while essential electrolytes are preserved and returned to the bloodstream, maintaining physiological balance. By regenerating and reusing the filtrate, this design eliminates the need for continuous replacement fluid, significantly reducing manual intervention, resource consumption, and waste generation. Our prototype uses potassium as a hyperkalemic model toxin. The system incorporates glass beads and glass wool to stabilize inlet and outlet flow and ensure uniform distribution. A sodium and calcium polystyrene based ion exchange resin is used to selectively bind potassium ions, while a fine membrane barrier prevents resin particle migration into the effluent stream. The adsorption column is centrally positioned within the system and sealed using a water-resistant sealant to maintain structural integrity and prevent leakage. Ethically, equitable access across diverse healthcare settings must be prioritized, particularly for rural and low-resource hospitals. In early clinical use, clear informed consent is essential due to the novel nature of the system, and use in non-consenting patients should be deferred until sufficient validation is achieved. Rigorous testing and adherence to regulatory standards are necessary to ensure safe and responsible clinical implementation. However, this device has the potential to improve patient outcomes and reduce clinical workload while increasing hospital efficiency.
