# Development of a CO2-bicarbonate combined membrane capture system for accessible treatment of acute respiratory failure.

> **NIH NIH R43** · X-COR THERAPEUTICS, INC. · 2021 · $293,121

## Abstract

PROJECT SUMMARY/ABSTRACT
X-COR Therapeutics is creating the first extracorporeal CO2 removal (ECCO2R) device that uses
dialysis-like approaches to accessibly treat hypercapnic respiratory failure (HRF) patients. HRF is a
devastating consequence of critical lung disease caused by chronic obstructive pulmonary disease (COPD)
and other respiratory disorders including acute respiratory distress syndrome (ARDS), a common complication
of COVID-19. The current standard of care for severe disease is invasive mechanical ventilation, which results
in a ~30% mortality rate and increased susceptibility to ARDS. While use of protective ventilatory strategies
reduces mortality, resultant hypercapnia from protective ventilation resembles diseases like COPD. In both
cases, impaired ventilation causes increased carbon dioxide (CO2) levels that lead to acidosis, coma, and
death. For patients with hypercapnia, extracorporeal technologies that deliver oxygen and remove gaseous
CO2 (e.g. ECMO) present possible alternatives but are highly invasive and costly. They require high blood flow
rates (>1 L/min) and large-bore cannula only deployable in specialized facilities.
Here, we propose investigating a hybrid device that resembles a hemodialysis-like blood filtration cartridge that
contains a novel configuration of two filtration fibers for bicarbonate dialysis and gaseous CO2 capture. High
efficiency CO2 removal allows a low blood rate of <250 ml/min, thus allowing small catheters (<13.5 Fr) to
replace the 28-30 Fr cannula used today in most extracorporeal therapies. Less invasive and standard
vascular access makes this therapy accessible and enables its use in parallel with invasive mechanical
ventilation. With parallel therapy, the proposed device can prevent hypercapnia that results from protective
ventilation and enable safer use of invasive mechanical ventilation with earlier extubation. Because it can use
existing hemodialysis systems, the device can be deployed with existing workflows and capital equipment.
The objective of this Phase I SBIR project is to optimize and then investigate ventilatory benefits from using a
hybrid membrane filtration device that removes CO2 from ultra-low extracorporeal blood flow. Aim 1 is to
determine optimal device geometries and operating parameters (e.g. size, fiber pack density, and fiber ratio)
that meet desired CO2 capture requirements through iterative modification of a novel design using scalable
production methods. Each iteration will be evaluated using bench-top ex-vivo perfusion testing. Aim 2 is to
investigate the impact that extracorporeal CO2 capture has on patient spontaneous and assisted ventilatory
requirements using a series of physiologic computational models using patient-specific boundary conditions.
Successful completion of this project will result in a manufacture-ready device with candidate geometries and
operating parameters for pre-clinical testing. This device will be able to: 1) remove >30% of CO2 produc...

## Key facts

- **NIH application ID:** 10258029
- **Project number:** 1R43HL158345-01
- **Recipient organization:** X-COR THERAPEUTICS, INC.
- **Principal Investigator:** Brian Yale Chang
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $293,121
- **Award type:** 1
- **Project period:** 2021-09-17 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10258029

## Citation

> US National Institutes of Health, RePORTER application 10258029, Development of a CO2-bicarbonate combined membrane capture system for accessible treatment of acute respiratory failure. (1R43HL158345-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10258029. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*