The self-expanding cannula exhibited superior venous drainage ability when compared to the performance of the standard rectilinear cannula with the use of the LifeBox. The flow rate achieved was approximately 40% greater than the standard drainage device, with a maximal pump flow recorded at 4.3l/min.
Most membrane oxygenators are built with microporous fibers known for plasma leakage in long-term use such as extracorporeal life support or extracorporeal membrane oxygenation. The current study was designed to evaluate the Quadrox oxygenator in which the fibers have been coated with silicone (Jostra). Six calves (mean weight, 62 +/- 4 kg) were connected to cardiopulmonary bypass (CPB) by jugular venous and carotid arterial cannulation, with a mean flow rate of 3 L/min for 6 hours. They were randomly assigned to a standard Quadrox oxygenator (standard group, n = 3) or a siliconized Quadrox oxygenator (silicone group, n = 3). After 7 days, the animals were sacrificed. A standard battery of blood samples was taken before bypass, after mixing for 10 minutes, and after 1, 2, 5, and 6 hours of perfusion. Analysis of variance was used for repeated measurements. Total oxygen transfer and carbon dioxide transfer did not differ between groups (p = 0.5 for comparison). Blood trauma, evaluated by plasma hemoglobin (Hb), did not detect any significant hemolysis in either group. Thrombocyte and white blood cell count profiles in both groups were parallel and without significant differences (p = 0.1 and 0.6, respectively). At the end of testing no clot deposition was found in the oxygenator. At postmortem, there were no signs of peripheral emboli. The results of this study suggest that this silicone coating of hollow fibers allows for good gas transfer, while preserving all the mechanical advantages of a conventional hollow fiber oxygenator.
The aim of this report is to address the benefits of the minimal invasive venous drainage in a pediatric cardio surgical scenario. Juvenile bovine experiments (67.4+/-11 kg) were performed. The right atrium was cannulated in a trans-jugular way by using the self-expandable (Smart Stat, 12/20F, 430 mm) venous cannula (Smartcannula LLC, Lausanne, Switzerland) vs. a 14F 250 mm (Polystan Lighthouse) standard pediatric venous cannula. Establishing the cardiopulmonary bypass (CPB), the blood flows were assessed for 20 mmHg, 30 mmHg and 40 mmHg of driving pressure. Venous drainage (flow in l/min) at 20 mmHg, 30 mmHg, and 40 mmHg drainage load was 0.26+/-0.1, 0.35+/-0.2 and 0.28+/-0.08 for the 14F standard vs. 1.31+/-0.22, 1.35+/-0.24 and 1.9+/-0.2 for the Smart Stat 12/20F cannula. The 43 cm self-expanding 12/20F Smartcannula outperforms the 14F standard cannula. The results described herein allow us to conclude that usage of the self-expanding Smartcannula also in the pediatric patients improves the flow and the drainage capacity, avoiding the insufficient and excessive drainage. We believe that similar results may be expected in the clinical settings.
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