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In Vitro Hemodynamic Evaluation of Five 6 F r and 8 F r Arterial Cannulae in Simulated Neonatal Cardiopulmonary Bypass Circuits
Author(s) -
Wang Shigang,
Palanzo David,
Kunselman Allen R.,
Ündar Akif
Publication year - 2016
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12579
Subject(s) - cardiopulmonary bypass , hemodynamics , in vitro , medicine , anesthesia , chemistry , cardiology , biochemistry
The objective of this study was to evaluate five small‐bore arterial cannulae (6 F r and 8 F r) in terms of pressure drop and hemodynamic performance in simulated neonatal cardiopulmonary bypass ( CPB ) circuits. The experimental circuits consisted of a J ostra HL ‐20 roller pump, a T erumo C apiox B aby FX 05 oxygenator with integrated arterial filter, an arterial and a venous tubing (1/4, 3/16, or 1/8 in × 150 cm), and an arterial cannula ( M edtronic B io‐ M edicus 6 F r and 8 F r, M aquet 6 F r and 8 F r, or RMI E dwards 8 F r). The circuit was primed using lactated Ringer's solution and heparinized packed human red blood cells (hematocrit 30%). Trials were conducted at different flow rates (6 F r: 200–400 mL/min; 8 F r: 200–600 mL/min) and temperatures (35 and 28°C). Flow and pressure data were collected using a custom‐based data acquisition system. Higher circuit pressure, circuit pressure drop, and hemodynamic energy loss across the circuit were recorded when using small‐bore arterial cannula and small inner diameter arterial tubing in a neonatal CPB circuit. The maximum preoxygenator pressures reached 449.7 ± 1.0 mm Hg ( M aquet 6 F r at 400 mL/min), and 395.7 ± 0.4 mm Hg ( DLP 8 F r at 600 mL/min) when using 1/8 in ID arterial tubing at 28°C. Hypothermia further increased circuit pressure drop and hemodynamic energy loss. Compared with the others, the RMI 8 F r arterial cannula had significantly lower pressure drop and energy loss. M aquet 6 F r arterial cannula had a greater pressure drop than the DLP 6 F r. A small‐bore arterial cannula and arterial tubing created high circuit pressure drop and hemodynamic energy loss. Appropriate arterial cannula and arterial tubing should be considered to match the expected flow rate. Larger cannula and tubing are recommended for neonatal CPB . Low‐resistance neonatal arterial cannulae need to be developed.