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聚甲基戊烯氧合器在成人体外膜肺氧合中具有改善的气体交换能力并减少了输血需求。

Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation.

作者信息

Khoshbin Espeed, Roberts Neil, Harvey Chris, Machin David, Killer Hilliary, Peek Giles J, Sosnowski Andrzej W, Firmin Richard K

机构信息

Division of Cardiac Surgery, University of Leicester, and the Heart link ECMO Center, Glenfield Hospital, University Hospitals of Leicester NHS trust, Groby road, Leicester, United Kingdom.

出版信息

ASAIO J. 2005 May-Jun;51(3):281-7. doi: 10.1097/01.mat.0000159741.33681.f1.

Abstract

The performance of poly-methyl pentene (PMP) oxygenators (Medos Hilite 7000LT) was compared with that of silicone membrane (SM) oxygenators (Medtronic 1-4500-2A) for adult extracorporeal membrane oxygenation (ECMO). Forty consecutive patients were selected retrospectively pre- and post-introduction of PMP oxygenators. They were selected according to the dates they received ECMO and were separated into two equal groups with similar backgrounds. The flow path resistance, gas and heat exchange efficiency, consumption of coagulation factors and platelets, blood transfusion requirements, and incidence of clots for each oxygenator type was assessed. Adult PMP oxygenators showed lower blood path resistance than SM oxygenators. However, lower consumption of blood products in these oxygenators was a direct result of their smaller surface area and heparin coated design, reducing contact activation of coagulation factors. These oxygenators are noticeably smaller, require lower priming volumes, and have better gas exchange capability than SM oxygenators. They showed greater stability and preservation of coagulation factors and platelets compared with SM oxygenators. They also had the advantage of a functioning integrated heat exchanger. Using a single PMP oxygenator in the first instance may be adequate for the majority of patients and would significantly reduce red blood cell consumption during ECMO.

摘要

将聚甲基戊烯(PMP)氧合器(Medos Hilite 7000LT)与硅酮膜(SM)氧合器(美敦力1-4500-2A)用于成人体外膜肺氧合(ECMO)的性能进行了比较。回顾性选取了40例连续使用PMP氧合器前后的患者。根据他们接受ECMO的日期进行选择,并分为两组,两组背景相似。评估了每种氧合器类型的血流路径阻力、气体和热交换效率、凝血因子和血小板的消耗、输血需求以及血栓发生率。成人PMP氧合器的血液路径阻力低于SM氧合器。然而,这些氧合器中血液制品消耗较低是其表面积较小和肝素涂层设计的直接结果,减少了凝血因子的接触激活。这些氧合器明显更小,预充量更低,并且气体交换能力比SM氧合器更好。与SM氧合器相比,它们在凝血因子和血小板的稳定性和保存方面表现更佳。它们还具有集成热交换器功能的优势。对于大多数患者,首先使用单个PMP氧合器可能就足够了,并且会显著减少ECMO期间红细胞的消耗。

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