Mobile Heart-Lung Machine Improves Heart Attack Survival

An advance mobile system for personalized control of extracorporeal circulation helps preserve brain function during resuscitation following cardiac arrest.

The Resuscitec (Freiburg, Germany) CARL system is designed to perform controlled automated reperfusion of the whole body in order to improve survival and neurologic recovery in patients affected by acute cardiac arrest. The system includes three main elements:

• CARL.CONTROLLER, a perfusion system with powerful, automated dual pump control to generate high pulsatile blood flow, a comprehensive measurement sensor system with online venous and arterial blood gas analysis and plug-in fibre optic catheter for invasive blood pressure monitoring, and a preconfigured, compact perfusion set for quick and easy system start-up.
• CARL. MOX, A mobile oxygen supply for controlled oxygenation and decarboxylation in the extracorporeal circuit. The resource-saving system makes use of room air by means of blower technology, precisely controlling O2 concentration (21 to 100%) and CO2 elimination (up to 12 l/min gas flow). The system can run for approximately four hours on battery power.
• The CARL.COOLER, a mobile hypothermia device for rapid therapeutic cooling in the context of extracorporeal circulation, which can provide up to 4 °C cooling capacity within a few minutes. A disposable cooler kit provides resource-independent cooling by endothermic reaction, with direct connection to the oxygenator.

The technological performance characteristics of the CARL System components are based on the requirements of CARL Therapy, a novel therapeutic approach for resuscitation that emphasizes controlled, targeted, and personalized whole-body reperfusion. The unique, dual-pump control system enables the powerful pulsatile blood flow necessary for maintaining high blood pressure, precise control of oxygen levels, and rapid, safe cooling of body temperature.

“Oxygen levels must be low and increased only slowly. Otherwise, free radicals are generated in the tissues. These very aggressive molecules can then attack, among other things, the mitochondria, the power plants of the cells,” said Professor Friedhelm Beyersdorf, MD, of the University of Freiburg, co-developer of CARL. “The CARL method incorporates the latest basic research and state-of-the-art cardiac techniques. After decades of research, we were able to develop a new treatment method to reduce the physical damage that would otherwise occur after cardiac arrest and resuscitation.”

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