Segers P A, Heida J F, de Vries I, Maas C, Boogaart A J, Eilander S
Department of Extracorporeal Circulation, Isala Clinics, Weezenlande Hospital, Zwolle.
Perfusion. 2001 Mar;16(2):95-106. doi: 10.1177/026765910101600203.
In a comparative study we investigated the performance characteristics of nine hollow-fibre oxygenators. In a clinical setting, 10 units of each type of oxygenator were tested for oxygen exchange, transoxygenator pressure drop, heat exchanger performance and blood trauma. The oxygenators included are Maxima PRF Plus, Affinity, Forte, Affinity NT, Quantum, Optima, Capiox 1.8, Hilite and Quadrox. Ninety patients scheduled for elective coronary bypass surgery were enrolled in the study. Cardiotomy suction blood was not allowed to mix with the circulating blood. Samples were taken preoperatively (t1), immediately after cooling and crossclamping of the aorta (t2), during rewarming (t3), and postoperatively (t4). The results showed that under clinical conditions all of the tested oxygenators are well capable of meeting the normal and above-normal oxygen needs. The Quantum and Affinity NT are the best performing oxygenators with respect to oxygen transfer. The Quantum oxygenator with a small membrane surface area of 1.9 m2 has also the highest oxygen transfer per square metre. A direct relationship between shunt fraction and blood flow could not be established in all oxygenators. The lowest shunt fraction at 4 litres blood flow was seen in the Maxima, Quantum and Affinity NT groups (15%). At near physiological PaO2-values, we noticed a negative influence on the shunt fraction. Large differences exist in pressure drop between the oxygenators under standardized conditions with circulating priming, as well as during bypass. The lowest pressure drop was noticed in the Quadrox and Affinity NT, the highest in the Quantum, Capiox and Optima. However, we did not measure any differences in pressure drop after cooling and during re-warming. Differences exist between the heat exchanger performances. The Quadrox oxygenator is the most efficient, while the Maxima has the smallest performance factor. It was not possible to calculate heat exchanger performance for the Hilite due to incorrect temperature measurement. The high pressure gradients in some of the devices did not result in higher haemolysis. Plasma free haemoglobin values were low in each oxygenator. There are no differences in platelet drop postoperatively. The influence on blood trauma of the higher pressure drop in some of the tested devices, in combination with the higher centrifugal pump revolutions needed to overcome this gradient, has to be studied with longer perfusion times.
在一项比较研究中，我们调查了九种中空纤维氧合器的性能特征。在临床环境中，对每种类型的氧合器各10个单元进行了氧交换、跨氧合器压降、热交换器性能和血液损伤方面的测试。所包括的氧合器有Maxima PRF Plus、Affinity、Forte、Affinity NT、Quantum、Optima、Capiox 1.8、Hilite和Quadrox。90例计划进行择期冠状动脉搭桥手术的患者被纳入该研究。不允许心内吸引血与循环血混合。在术前（t1）、主动脉冷却和交叉钳夹后立即（t2）、复温期间（t3）和术后（t4）采集样本。结果表明，在临床条件下，所有测试的氧合器都能很好地满足正常及高于正常的氧需求。就氧传递而言，Quantum和Affinity NT是性能最佳的氧合器。膜表面积为1.9平方米的Quantum氧合器每平方米的氧传递率也最高。并非所有氧合器都能确定分流分数与血流量之间的直接关系。在血流量为4升时，Maxima、Quantum和Affinity NT组的分流分数最低（15%）。在接近生理PaO2值时，我们注意到对分流分数有负面影响。在标准化的循环预充条件下以及体外循环期间，氧合器之间的压降存在很大差异。Quadrox和Affinity NT的压降最低，Quantum、Capiox和Optima的压降最高。然而，我们在冷却后和复温期间未测量到压降的任何差异。热交换器性能之间存在差异。Quadrox氧合器效率最高，而Maxima的性能系数最小。由于温度测量错误，无法计算Hilite的热交换器性能。一些设备中的高压梯度并未导致更高的溶血。每个氧合器中的血浆游离血红蛋白值都很低。术后血小板减少没有差异。一些测试设备中较高的压降，以及克服该梯度所需的较高离心泵转速对血液损伤的影响，必须通过更长的灌注时间进行研究。
