Alon L, Turina M, Gattiker R
Herz. 1979 Feb;4(1):56-62.
Forty patients undergoing aortocoronary bypass procedures were randomyl allocated to a bubble oxygenator group (20 patients) and a membrane oxygenator group (20 patients). Blood chemistry, hematology and hemodynamics before, during and after cardiopulmonary bypass were used to compare the two oxygenators. There was no mortality and no serious complications in both groups. A higher hemolysis, with significantly higher levels of lactic dehydrogenase and free plasma hemoglobin and a more pronounced reduction in platelet count were found in the patients perfused with the bubble oxygenator. These differences persisted for 24 hours after the operation; 48 hours after surgery no significant differences between the two groups could be detected. Postoperative blood loss, intra- and postoperative hemodynamics and pulmonary gas exchange were equal in both groups. These results show, that the routine use of membrane oxygenators brings only minor benefits; therefore it may be specially reserved for extended open-heart procedures and for operations in high risk patients.
40例行主动脉冠状动脉搭桥手术的患者被随机分为鼓泡式氧合器组(20例患者)和膜式氧合器组(20例患者)。通过比较体外循环前、中、后的血液化学、血液学和血流动力学指标来评估两种氧合器。两组均无死亡病例和严重并发症。使用鼓泡式氧合器灌注的患者出现了更高的溶血率,乳酸脱氢酶和游离血浆血红蛋白水平显著升高,血小板计数下降更为明显。这些差异在术后24小时持续存在;术后48小时两组之间未发现显著差异。两组术后失血量、术中和术后血流动力学以及肺气体交换情况相当。这些结果表明,常规使用膜式氧合器仅带来微小益处;因此,它可能特别适用于延长的心脏直视手术和高危患者的手术。