Seraph-100 Microbind Affinity Blood Filter Flow Driven by the Extracorporeal Membrane Oxygenation Circuit in Extracorporeal Membrane Oxygenation Patients

INTRODUCTION: The Seraph-100 Microbind Affinity Blood Filter is a novel therapy for extracorporeal blood-borne pathogen removal. To guarantee adequate therapy, the Seraph-100 relies on specific blood flows over a set treatment time which is achieved by providing Seraph-100 through a dialysis machine. Septic patients on extracorporeal membrane oxygenation (ECMO) support but not on renal replacement have received Seraph-100 therapy through the ECMO circuit with the ECMO pump driving flows. However, there are limited data to prove that this strategy, which avoids the use of a dialysis machine, achieves therapeutic flow rates through the Seraph-100 filter. METHODS: Our experiment involving swine models was conducted in detail with a configuration to connect the Seraph-100 circuit to the ECMO circuit and have blood flow through the filter in parallel with the patient. Seraph-100 flows were recorded at incremental changes in ECMO blood flow between 1.5 L/min and 5 L/min. RESULTS: With flows as low as 1.5 L/min, Seraph-100 flows averaged 137.27 mL/min (95% PI: 88-223 mL/min). When ECMO flow was 5 L/min, Seraph-100 flows averaged 356.50 mL/min (95% PI: 272-536 mL/min). Adding the Seraph-100 circuit caused ECMO revolutions per minute (RPMs) to increase by 31.2 (p < 0.05) and venous pressures to drop by -3.47 mm Hg (p < 0.05) to maintain the same ECMO blood flow. CONCLUSION: Connecting a Seraph-100 filter directly to an ECMO circuit and having Seraph-100 blood flow driven by the ECMO pump is feasible. This configuration achieves adequate flows for clinical therapy and has minimal changes in ECMO dynamics.