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 is 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 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 mmHg (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.
Thomas et al. (Mon,) studied this question.