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中空纤维膜表面积对氧合器性能的影响:迪德科D903 Avant与具有更大表面积的原型产品对比

Impact of hollow-fiber membrane surface area on oxygenator performance: Dideco D903 Avant versus a prototype with larger surface area.

作者信息

Mueller X M, Tevaearai H T, Jegger D, Boone Y, Augstburger M, von Segesser L K

机构信息

Clinic for Cardiovascular Surgery, CHUV (Centre Hospitalier Universitaire Vaudois), Switzerland.

出版信息

J Extra Corpor Technol. 2000 Sep;32(3):152-7.

Abstract

This study compares the gas transfer capacity, the blood trauma, and the blood path resistance of the hollow-fiber membrane oxygenator Dideco D 903 with a surface area of 1.7 m2 (oxygenator 1.7) versus a prototype built on the same principles but with a surface area of 2 m2 (oxygenator 2). Six calves (mean body weight: 68.2 +/- 3.2 kg) were connected to cardiopulmonary bypass (CPB) by jugular venous and carotid arterial cannulation, with a mean flow rate of 4 l/min for 6 h. They were randomly assigned to oxygenator 1.7 (N = 3) or 2 (N = 3). After 7 days, the animals were sacrificed. A standard battery of blood samples was taken before the bypass, throughout the bypass, and 24 h, 48 h, and 7 days after the bypass. The oxygenator 2 group showed significantly better total oxygen and carbon dioxide transfer values throughout the perfusion (p < .001 for both comparison). Hemolytic parameters (lactate dehydrogenase and free plasma hemoglobin) exhibited a slight but significant increase after 5 h of bypass in the oxygenator 1.7 group. The pressure drop through the oxygenator was low in both groups (range, 43-74 mmHg). With this type of hollow-fiber membrane oxygenator, an increased surface of gas exchange from 1.7 m2 to 2 m2 improves gas transfer, with a limited impact on blood trauma and no increase of blood path resistance.

摘要

本研究比较了表面积为1.7平方米的中空纤维膜式氧合器Dideco D 903(氧合器1.7)与基于相同原理构建但表面积为2平方米的原型氧合器(氧合器2)的气体传输能力、血液损伤和血液通路阻力。六只小牛(平均体重:68.2±3.2千克)通过颈静脉和颈动脉插管连接到体外循环(CPB),平均流速为4升/分钟,持续6小时。它们被随机分配到氧合器1.7组(N = 3)或氧合器2组(N = 3)。7天后,处死动物。在体外循环前、体外循环期间以及体外循环后24小时、48小时和7天采集标准系列血液样本。氧合器2组在整个灌注过程中显示出明显更好的总氧和二氧化碳传输值(两种比较均p <.001)。在氧合器1.7组中,体外循环5小时后溶血参数(乳酸脱氢酶和游离血浆血红蛋白)略有但显著增加。两组中通过氧合器的压降都很低(范围为43 - 74 mmHg)。对于这种类型的中空纤维膜式氧合器,气体交换表面积从1.7平方米增加到2平方米可改善气体传输,对血液损伤的影响有限,且不会增加血液通路阻力。

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