Clinical evaluation of the oxygenation capacity and controllability of 15 commercially available membrane oxygenators during alpha-stat regulated hypothermic cardiopulmonary bypass

Abstract

Oxygenation performance was tested in 15 membrane oxygenators by calculating the resistance for oxygenation (R) and the calculation of oxygen transferred versus FiO₂. The clinical data reveal that the SARNS Turbo 440 (36.7-51.9%), the AFFINITY (37.2-50.1 %) and the HF 5400 (37.5-52.3%) are the oxygenators with the lowest FiO₂ settings for comparable amounts of oxygen transferred during hypothermia and during normothermia followed by MAXIMA Plus (39.1-55.8%), MAXIMA Plus PRF (39.1-56.2%), CAPIOX SX 18 (39.7-61.2%), MONOLYTH (43.0-61.3%), OXIM 11-34 (44.1-63.9%), COBE Duo (44.7-64.9%), COBE Optima (47.4-66.4%), COMPACTFLO (48.3-65.3%), SAFE II (49.0-67.6%), UNIVOX (49.8-71.3%), MAXIMA (50.2-70.1 %) and the CM 50 (58.6-77.0%). Similar results were found by calculation of R. HF 5400 (2.41-1.87 mmHg/min/ml O₂), AFFINITY (2.63-1.87 mmHg/min/ml O₂), OXIM II-34 (2.72-2.45 mmHg/min/ml O₂), MAXIMA Plus PRF (2.75-2.07 mmHg/min/ ml O₂), COBE Optima (2.83-2.13 mmHg/min/ml O₂), UNIVOX (2.84-2.17 mmHg/min/ml O₂), MONOLYTH (2.89-2.24 mmHg/min/ml O₂), SARNS Turbo 440 (3.03-2.12 mmHg/min/ml O₂), MAXIMA Plus (3.09-2.28 mmHg/min/ml O₂), SAFE 11 (3.19-2.50 mmHg/min/ml O₂), CAPIOX SX 18 (3.27-2.44 mmHg/ min/ml O₂), COMPACTFLO (3.41-2.50 mmHg/min/ml O₂), MAXIMA (3.53-2.72 mmHg/min/ml O₂), COBE Duo (3.57-2.71 mmHg/min/ml O₂) and the CM 50 (3.53-2.72 mmHg/min/ml O₂). As a measure of controllability of oxygenation, the coefficient of variation on the FiO₂ ordered on the normothermic blood samples was used, giving as a result CAPIOX SX 18 (2.9-2.5%), AFFINITY (3.6-3.5%), COBE Duo (4.3-2.9%), HF 5400 (5.7-4.7%), MAXIMA Plus (8.1- 5.4%), COMPACTFLO (8.2-5.0%), MONOLYTH (8.3-4.0%), MAXIMA (8.7- 3.4%), COBE Optima (9.6-6.8%), SARNS Turbo 440 (10.1-7.3%), MAXIMA Plus PRF (10.9-8.7%), CM 50 (11.9-2.4%), UNIVOX (13.3-8.9%), OXIM 11-34 (15.5-17.3%) and the SAFE II (16.1-9.8%). The low FiO₂ settings and the lower resistance for oxygenation are an indication of the reserve capacity of the oxygenators whose importance is proven by clinical data of emergency perfusions on patients under full resuscitation.

Get full access to this article

View all access options for this article.

References

Gourlay T. , Fleming J. , Taylor KM , Aslam M. Evaluation of a range of extracorporeal membrane oxygenators. Perfusion 1990; 5: 117-33.

Rahn A. , Prakash O. Acid-base regulation and body temperature. Martinus Nijhoff , 1985.

Fried DW , Bell-Thomson J. Oxygen transfer efficiency of three microporous polypropylene membrane oxygenators . Perfusion 1991; 6: 105-14.

Fried DW , Bell-Thomson J. A comparison of two oxygen transfer strategies: Bentley Univox and the Bard HF 5400. Perfusion 1992; 7: 141-48.

Fried DW , Bell-Thomson J. Oxygen transfer performance of a new Sarns membrane oxygenator. Perfusion 1992; 7: 263-71.

Curtis RM , Eberhart RC

Normalisation of oxygen transfer data in membrane oxygenators. Trans Am Soc

Artif Organs 1974; XX: 210-18.

Chan R. Gas exchange reserve capabilities of membrane oxygenators in vitro: a comparison . Amsect proceedings 1985: 45-49.

Fried DW , Bell-Thomson J. The clinical significance of the oxygen transfer slope. Perfusion 1993; 8: 169-75.

De Somer F. , De Smet D. , Vanackere M. , van Nooten G. , Caes F. , Delaughe J. Clinical evaluation of a new hollow fibre membrane oxygenator. Perfusion 1994; 9: 57-64.