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Comparison of Perfusion Quality in Hollow‐Fiber Membrane Oxygenators for Neonatal Extracorporeal Life Support
Author(s) -
Talor Jonathan,
Yee Stella,
Rider Alan,
Kunselman Allen R.,
Guan Yulong,
Ündar Akif
Publication year - 2010
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/j.1525-1594.2009.00971.x
Subject(s) - pulsatile flow , oxygenator , perfusion , medicine , membrane oxygenator , hemodynamics , extracorporeal , cardiopulmonary bypass , peristaltic pump , extracorporeal membrane oxygenation , blood flow , hematocrit , cardiology , anesthesia , physics , meteorology
Perfusion quality is an important issue in extracorporeal life support (ECLS); without adequate perfusion of the brain and other vital organs, multiorgan dysfunction and other deficits can result. The authors tested three different pediatric oxygenators (Medos Hilite 800 LT, Medtronic Minimax Plus, and Capiox Baby RX) to determine which gives the highest quality of perfusion at flow rates of 400, 600, and 800 mL/min using human blood (36°C, 40% hematocrit) under both nonpulsatile and pulsatile flow conditions. Clinically identical equipment and a pseudo‐patient were used to mimic operating conditions during neonatal ECLS. Traditionally, the postoxygenator surplus hemodynamic energy value (SHE post , extra energy obtained through pulsatile flow) is the one relied upon to give a qualitative determination of the amount of perfusion in the patient; the authors also examined SHE retention through the membrane, as well as the contribution of SHE post to the postoxygenator total hemodynamic energy (THE post ). At each experimental condition, pulsatile flow outperformed nonpulsatile flow for all factors contributing to perfusion quality: the SHE post values for pulsatile flow were 4.6–7.6 times greater than for nonpulsatile flow, while the THE post remained nearly constant for pulsatile versus nonpulsatile flow. For both pulsatile and nonpulsatile flow, the Capiox Baby RX oxygenator was found to deliver the highest quality of perfusion, while the Minimax Plus oxygenator delivered the least perfusion. It is the authors' recommendation that the Baby RX oxygenator running under pulsatile flow conditions be used for pediatric ECLS, but further studies need to be done in order to establish its effectiveness beyond the FDA‐approved time span.