Stammers A H, Fristoe L W, Alonso A, Song Z, Galbraith T
Division of Clinical Perfusion Education, University of Nebraska Medical Center, Omaha 68198-5155, USA.
Perfusion. 1998 May;13(3):165-75. doi: 10.1177/026765919801300303.
A new generation hollow-fibre membrane oxygenator (Spiral Gold) has been introduced by Baxter Healthcare (Irvine, CA, USA). The purpose of this study was to evaluate the operational performance of this device under clinical conditions and to compare it to the Univox Gold membrane oxygenator. Following institutional review board approval, and the obtainment of informed consent, 26 patients undergoing coronary artery bypass grafting were randomly assigned to either a Spiral Gold (Spiral) (n = 13) or Univox Gold (Univox) (n = 13) group. Study parameters were grouped into the following categories: haematological, haemodynamic, oxygenator performance and perioperative outcomes. All patients received identical surgical, anaesthesia and postoperative care. There were no statistically significant differences in either preoperative or operative parameters between groups. During cardiopulmonary bypass, the Spiral group had a significantly lower pressure drop (26.9 +/- 8.2 vs 46.7 +/- 16.2 mmHg, p < 0.001). The Spiral group had significantly lower plasma free haemoglobin levels during all time periods of CPB compared to the Univox group. Heat exchange coefficients were higher during the rewarming period in the Spiral patients (0.59 +/- 0.28) compared to the Univox group (0.36 +/- 0.19), p = 0.06. There were no differences in oxygen transfer between groups, but ventilation gas sweep rates and FiO2 levels were statistically lower in the Spiral group at two of the three sampling time periods. The ratio of ventilating gas sweep rate to blood flow rate was lower in the Spiral group (0.56 +/- 0.12) compared to the Univox group (0.74 +/- 0.23), p < 0.03. The Spiral Gold oxygenator had superior oxygen transfer efficiency and lower haemolysis rates than the Univox Gold oxygenator.
百特医疗保健公司(美国加利福尼亚州欧文市)推出了新一代中空纤维膜式氧合器(螺旋金)。本研究的目的是评估该设备在临床条件下的运行性能,并将其与尤尼沃克斯金膜式氧合器进行比较。经机构审查委员会批准并获得知情同意后,26例行冠状动脉旁路移植术的患者被随机分为螺旋金组(螺旋组)(n = 13)或尤尼沃克斯金组(尤尼沃克斯组)(n = 13)。研究参数分为以下几类:血液学、血流动力学、氧合器性能和围手术期结果。所有患者均接受相同的手术、麻醉和术后护理。两组患者术前或手术参数均无统计学显著差异。在体外循环期间,螺旋组的压力降显著更低(26.9±8.2 vs 46.7±16.2 mmHg,p < 0.001)。与尤尼沃克斯组相比,螺旋组在体外循环的所有时间段内血浆游离血红蛋白水平均显著更低。在复温期,螺旋组患者的热交换系数(0.59±0.28)高于尤尼沃克斯组(0.36±0.19),p = 0.06。两组之间的氧传递无差异,但在三个采样时间段中的两个时间段,螺旋组的通气气体吹扫率和FiO2水平在统计学上更低。与尤尼沃克斯组(0.74±0.23)相比,螺旋组的通气气体吹扫率与血流率之比更低(0.56±0.12),p < 0.03。螺旋金氧合器比尤尼沃克斯金氧合器具有更高的氧传递效率和更低的溶血率。