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Artificial lung
An artificial lung is an implantable prosthetic device that is able to convert environmental air into oxygen and is powered by the heart’s natural blood pumping power. Although the FDA has not yet approved any devices, various research teams worldwide are currently developing several artificial lung devices.

Short-term lung replacement
Advanced Platform Technology (APT) artificial lung

The APT artificial lung was developed by a team lead by Joe Potkay, a research assistant professor at Case Western Reserve University in Cleveland, Ohio. Potkay’s team built their prototype according to the natural human lung’s anatomical design and spatial dimensions.[1] The blood vessels in the artificial lung are constructed out of silicone rubber using an organic silicon polymer called PDMS.[1]  The constructed blood vessels are less than one-fourth the diameter of human hair, similar to the diameter of arteries and capillaries in a biological human lung.[1]   Blood and air flow outlets and inlets were added to the vessel walls.[1]   This device is capable of being powered by the heart’s natural blood-pumping force and requires no additional mechanical pump.[1]

The life-like design of the device allows it to have a large surface-area-to-volume ratio in order to minimize the distances for gas diffusion, therefore increasing gas exchange efficiency.[1]  The oxygen exchange efficiency is up to five times better than previous respiration devices.[1]   This high exchange efficiency is what allows the device to use environmental air and not require an oxygen tank.[1] Potkay’s team is now working with researchers from Case Western Reserve’s biomedical engineering and chemical engineering departments in an effort to develop a material that would prevent clogging in the artificial capillaries in the device. Within the next decade, Potkay’s artificial lung the device is expected to be approved for use in clinical trials and eventually use for implantation in patients.[2]

BioLung

Robert Bartlett, MD, a surgeon at the University of Michigan Medical Center, is currently leading a research team in the development of the BioLung. For the past decade, Bartlett’s team has been working on constructing an artificial lung and powered by the heart and capable of supplying patients with oxygen at the same capacity of biological lungs.[3] The patient's heart would pump blood into the BioLung, which contains tiny holes that allow gas exchange.[3] The holes allow the release of carbon dioxide and the influx of oxygen.[3] The oxygenated blood would then be pumped back into the heart, and then to the rest of the body.

The BioLung is in the process of being approved by the FDA.[3]

Long-term lung replacement
I3-Assist

The I3-Assist was invented by a team of biomedical engineers at RWTH Aachen University in Germany and is the first artificial lung being developed for permanent lung replacement.

Unlike any other artificial lung devices, the I3-Assist can be implanted both short- and long-term. Scientists have constructed the I3-Asssist Device using synthetic material that can be shaped and cut into multiple dimensions, allowing the device to be customized according the patients’ needs.[4]

In 2011, the I3-Assist won the Biomedical Engineering Award in Philadelphia.[4]

Artificial lung synthesis using stem cells
Artificial lungs made from stem cells are constructed entirely out of biological material, meaning no machinery is necessary, and, therefore, there is less risk of infection. Two research teams at Harvard Medical School in Boston, Massachusetts have grown artificial lungs in rats using stem cells. Scientists have successfully degraded native lung tissue extracted from rats, coated the remaining connective tissue scaffold with new proteins from stem cells, and implanted the newly grown lungs back into rats.[5] However 6 hours after the implantation, the rats died due to fluid accumulation.[5]

Early artificial breathing machines
Different than transplantable artificial lungs, artificial breathing devices are external machines that imitate the gas exchange function of a biological lung. These machines require oxygen tanks, limiting users’ mobility. These machines have inefficient oxygen conversion rates and can only be used by patients at rest.

ECMO

Extracorporeal membrane oxygenation (ECMO) machines can be used to regulate the functions of both the lungs and heart.[6] The ECMO machine works by pumping blood and exchanging carbon dioxide for oxygen outside the body.[6] This machine is designed for patients who have had respiratory failure due to infections or trauma and only require temporary care.[6] Patients using an ECMO machine are required to take blood thinners, to prevent clotting as their blood passes through the machine, which can cause severe bleeding.[6]

Clinical Use
Patients suffering from terminal lung diseases such as: cystic fibrosis, lung cancer or chronic obstructive pulmonary disease, currently have to rely on biological lung transplants.[1] Waiting for donor organs and transplantation surgery can take years, which is often greater than the life-expectancy of most patients Then there is also the significant possibility that the patients’ body will reject the foreign donor organs. The majority of these devices are designed to be only a temporary substitute for normal lung function, while patients’ diseased lungs heal or while waiting for a biological lung transplant.[1] The lifetime expectancy of these devices is only a few years and they are not a means of permanent lung replacement.[1]

First clinical implantation of a partial artificial lung
On October 28th 2009, Dr. Emmanuel Martinod and a team of surgeons at the Avicenne Hospital in Paris successfully replaced a portion of the lungs of a 78-year-old lung cancer patient with an artificial lung. Scientists constructed this artificial lung using biological material from a tissue bank, preventing the need for anti-rejection treatment.[7]

First clinical implantation of a total artificial lung
On June 10 2011, doctors at St. Louis Children's Hospital successfully implanted a German-built artificial lung device into 2-year-old patient after his lungs suddenly collapsed. Although the FDA has not yet approved the device, the doctors successfully petitioned for its temporary use due to the extreme circumstances.8 The device allowed the patient’s natural lungs to nearly fully recover.[8] However three weeks the implantation of the artificial lung, the patient suffered a stroke and the device was removed.[8]