Clinical evaluation of the Admiral 1.35m2 hollow-fibre membrane oxygenator

Abstract

This prospective study was designed to evaluate the fundamental clinical performance of a new, small surface area oxygenator. Data were collected from twenty patients undergoing first-time coronary artery bypass grafting using this device. This study focuses on how the reduction of surface area and prime volume affects the essential function of the oxygenator in terms of oxygenation efficiency, heat transference, membrane pressure drops, haemolysis and safety. Oxygenation efficiency was deemed to be well within acceptable margins, even at high flows, over a temperature range of 32-36°C. Heat-exchanger performance was assessed by recording the heater/chiller water temperature compared to retrospective data from a current standard oxygenator. Heater/chiller water temperatures were on average 0.3°C higher with the small surface oxygenator than the standard data. The air handling of the device was excellent and extremely safe. Haemolysis, measured as plasma free haemoglobin, did not increase during bypass (p>0.05). This new oxygenator offers a reduced surface area and priming volume while still ensuring an acceptable safety reserve and performance.

Get full access to this article

View all access options for this article.

References

1 Singh HP Coleman ET Hangrove M Barrow SE Murphy MB Aherne T . Prostacyclin and thromboxane levels in pleural space fluid during cardiopulmonary bypass. Ann Thorac Surg 1995; 59: 17–50.

2 Hansbro SD Sharpe DAC Welsh KR . Haemolysis during cardiopulmonary bypass: an in vivo comparison of standard roller pumps, nonocclusive roller pumps and centrifugal pumps. Perfusion 1999; 14: 3–10.

3 Kirklin JW Barratt-Boyes BG . Cardiac Surgery, 2nd ed. New York: Churchill Livingstone, 1993:83.

4 Cormack JE Forest RJ Groom RC Morton J . Size makes a difference: use of a low-prime cardiopulmonary bypass circuit and autologous priming in small adults. Perfusion 2000; 15: 129–135.

5 Mueller XM Jegger D Augstburger M Horisberger J Godar G von Segesser LK . A new concept of integrated cardiopulmonary bypass circuit. Eur J Cardiothorac Surg 2002; 21: 840–846.

6 Rousou JA Engelman RM Flack JE Deaton DW Garb JL Owen SG . The ‘primeless pump’: a novel technique for intraoperative blood conservation. Cardiovasc Surg 1999; 7: 228–235.

7 Fisher AR Baker M Buffin M . Normal and abnormal trans-oxygenator pressure gradients during cardiopulmonary bypass. Perfusion 2003; 18: 25–30.

8 American National Standards Institute Association for the Advancement of Medical Instrumentation. Cardiovascular implants and artificial organs – Blood-gas exchangers. International Organisation for Standardisation (ISO) 7199; 1996.

9 Pierangeli A Masieri V Bruzzi F . Haemolysis during cardiopulmonary bypass: how to reduce the free haemoglobin by managing the suctioned blood separately. Perfusion 2001; 16: 519–524.