Kim W G, Yoon C J
Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University Hospital, Korea.
Artif Organs. 1998 Oct;22(10):892-7. doi: 10.1046/j.1525-1594.1998.06188.x.
Tubing wear and spallation have long been recognized as complications of roller pumps used in cardiopulmonary bypass (CPB) although the reported results of studies of polyvinylchloride (PVC) and silicone rubber tubing wear are still controversial. We conducted phase-contrast microscope (PCM) and scanning electron microscope (SEM) studies of roller pump induced tubing wear. A closed CPB circuit was constructed, and both PVC and silicone rubber tubing (1/2 inch internal diameter [ID]) were tested under normal and tight occlusions of a dual roller pump at a typical CPB flow rate (4,500 ml/min) for 1, 2, 4, and 6 h in quintet. After each pump run, the tubing was removed. It was first examined with PCM, and suspicious portions were then analyzed in detail using SEM. In silicone rubber tubing of longer running time, the external diameter often decreased. Wear was invariably found on the luminal surfaces at the junction of the inner and outer walls of both the PVC and silicone rubber tubing with no significant differences between normal and tight occlusion. The grooves in the PVC tubing were narrow and continuous with occasional deep cracks in the tubing after more than 3 h of pump run. The grooves in the silicone rubber tubing were wide and often interrupted with occasional V-shaped elevated areas. Craters of less than 50 microns occurred sporadically in both types of tubing. Neither PVC nor silicone rubber tubing offers advantages in terms of roller pump induced tubing wear and spallation.
尽管关于聚氯乙烯(PVC)和硅橡胶管道磨损的研究报告结果仍存在争议,但管道磨损和剥落长期以来一直被认为是体外循环(CPB)中使用的滚压泵的并发症。我们对滚压泵引起的管道磨损进行了相差显微镜(PCM)和扫描电子显微镜(SEM)研究。构建了一个封闭的CPB回路,在典型的CPB流速(4500毫升/分钟)下,对PVC和硅橡胶管道(内径1/2英寸)在双滚压泵正常和紧密阻塞的情况下进行了5组1、2、4和6小时的测试。每次泵运行后,取出管道。首先用PCM检查,然后对可疑部分用SEM进行详细分析。在运行时间较长的硅橡胶管道中,外径通常会减小。在PVC和硅橡胶管道内外壁交界处的管腔内表面总是发现磨损,正常阻塞和紧密阻塞之间没有显著差异。泵运行超过3小时后,PVC管道中的凹槽狭窄且连续,管道偶尔会出现深裂缝。硅橡胶管道中的凹槽较宽,且经常中断,偶尔会有V形隆起区域。两种类型的管道中偶尔会出现小于50微米的凹坑。就滚压泵引起的管道磨损和剥落而言,PVC和硅橡胶管道都没有优势。