Guan Yulong, Su Xiaowei, McCoach Robert, Wise Robert, Kunselman Allen, Undar Akif
Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Milton S. Hershey Medical Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, Pennsylvania 17033-0850, USA.
J Extra Corpor Technol. 2010 Jun;42(2):134-8.
Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass procedures in adult as well as pediatric cardiac surgery patients. The present study tested the effectiveness of a new adult membrane oxygenator in models both with and without an integrated arterial filter to evaluate GME trapping capability and determine membrane pressure drops at various flow rates and temperatures. The experimental circuit included a RotaFlow centrifugal blood pump, Quadrox-i (n = 8) or Quadrox (n = 8) adult microporous membrane oxygenator, and Sorin adult tubing package. A Sorin Cardiovascular VVR 4000i venous reservoir served as pseudo-patient. The circuit was primed with 900 mL heparinized human red blood cells and 300 mL Lactated Ringer's solution. The final hematocrit was 36%. Tests were performed at different flow rates (4 L/min, 5 L/min, and 6 L/min) and temperatures (35 degrees and 30 degrees). Five mL of bolus air was injected into the venous line over 15 seconds using a syringe connected to a 3/8 x 1/2 luer connector. The Quadrox-i adult microporous membrane oxygenator with integrated arterial filter had a similar pressure drop at 4 L/min and 35 degrees C compared with Quadrox membrane oxygenator whereas it had higher pressure drops at 5 L/min and 6 L/min (p < .001). Quadrox-i adult microporous membrane oxygenator reduced the total emboli count and total emboli volume delivered to the pseudo-patient at all flow rates (p < .001).The emboli handling of Quadrox-i adult microporous membrane oxygenator was not affected by flow rate and temperature. Compared with the traditional Quadrox oxygenator, Quadrox-i adult microporous membrane oxygenator with integrated arterial filter and Softline coating has improved GME handling capacity.
气态微栓子(GME)仍然是成人及小儿心脏手术患者体外循环手术面临的一项挑战。本研究在有和没有集成动脉滤器的模型中测试了一种新型成人膜式氧合器的有效性,以评估GME捕获能力,并确定不同流速和温度下的膜压力降。实验回路包括一台RotaFlow离心血泵、Quadrox-i(n = 8)或Quadrox(n = 8)成人微孔膜式氧合器以及索林成人管路套件。一台索林心血管VVR 400i静脉贮血器用作模拟患者。回路用900 mL肝素化人红细胞和300 mL乳酸林格氏液预充。最终血细胞比容为36%。测试在不同流速(4 L/分钟、5 L/分钟和6 L/分钟)和温度(35摄氏度和30摄氏度)下进行。使用连接到3/8×1/2鲁尔接头的注射器在15秒内将5 mL团注空气注入静脉管路。与Quadrox膜式氧合器相比,带有集成动脉滤器的Quadrox-i成人微孔膜式氧合器在4 L/分钟和35摄氏度时的压力降相似,而在5 L/分钟和6 L/分钟时压力降更高(p < 0.001)。Quadrox-i成人微孔膜式氧合器在所有流速下均减少了输送到模拟患者的总栓子计数和总栓子体积(p < 0.001)。Quadrox-i成人微孔膜式氧合器的栓子处理不受流速和温度影响。与传统的Quadrox氧合器相比,带有集成动脉滤器和Softline涂层的Quadrox-i成人微孔膜式氧合器具有更好的GME处理能力。