Heparin surface treatment does not impair gas and heat transfer of an extracorporeal circuit

Boonstra, PW; Akkerman, C.; Tigchelaar, Izaak; Gu, Yongquan; Huyzen, RJ; Eijgelaar, A

doi:10.1177/026765919200700205

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…The clinical performance of the oxygenator, mainly the gas exchange part, was determined by a Ciba Corning analyzer (Model 865, Medfield, MA). Oxygen (O 2 ) transfer and carbon dioxide (CO 2 ) transfer were calculated according to the standard formula (15).…”

Section: Methodsmentioning

confidence: 99%

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Gu¹,

Boonstra²,

Graaff

et al. 2000

Artificial Organs

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The membrane oxygenator is known to be superior to the bubble oxygenator, but little information is available about the difference between the hollow fiber and flat sheet membrane oxygenators with regard to pressure drop, shear stress, and leukocyte activation. In this study, we compared these 2 types of membrane oxygenators in patients undergoing cardiopulmonary bypass (CPB) surgery with special focus on leukocyte activation and pressure drop across the oxygenators. Plasma concentration of elastase, a marker indicating leukocyte activation, increased to 593+/-68% in the flat sheet oxygenator group versus 197+/-42% in the hollow fiber oxygenator group (p<0.01) at the end of CPB compared to their respective baseline concentrations before CPB. Pressure drop across the oxygenator was significantly higher in the flat sheet group than in the hollow fiber group throughout the entire period of CPB (p<0.01). High pressure drop across the oxygenator as well as the calculated shear stress was positively correlated with the release of elastase at the end of CPB (r = 0.760, p<0.01, r = 0.692, p<0.01). However, this positive correlation existed in the flat sheet oxygenator but not in the hollow fiber oxygenator. Clinically, both membrane oxygenators have satisfactory performance in O2 and CO2 transfer. These results suggest that a higher pressure drop across the flat sheet oxygenator is associated with more pronounced activation of leukocytes in patients undergoing cardiopulmonary bypass.

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Section: Methodsmentioning

confidence: 99%

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Gu¹,

Boonstra²,

Graaff

et al. 2000

Artificial Organs

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Oxygen-transfer performance of a newly designed, very low-volume membrane oxygenator

Burn

Ciocan

Carmona

et al. 2015

Interact CardioVasc Thorac Surg

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Comparison of Three Commercially Available Hollow Fiber Oxygenators: Gas Transfer Performance and Biocompatibility

Vroege¹,

Wagemakers²,

Velthuis³

et al. 2001

ASAIO Journal

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The new generation of oxygenators have improved blood flow pathways that enable reduction in priming volume and, thus, hemodilution during cardiopulmonary bypass (CPB). We evaluated three oxygenators and two sizes of venous reservoirs in relation to priming volume, gas transfer, and blood activation. To compare priming volume, gas transfer, and biocompatibility of three hollow fiber oxygenators and two different size venous reservoirs, 60 patients were randomly allocated in groups to undergo cardiopulmonary bypass. In each group, an oxygenator with a different surface area and priming volume was used: 1.8 m2 and 220 ml (group 1, n = 23), 2.2 m2 and 290 ml (group 2, n = 20), and 2.5 m2 and 270 ml (group 3, n = 17). In groups 1 and 3, a large soft shell (1900 ml) venous reservoir was used, whereas in group 2, a smaller soft shell (600 ml) venous reservoir was used. Gas transfer was assessed by calculating the oxygen transfer rate for each group and per square meter for each oxygenator group. Partial arterial oxygen pressure (paO2) and partial arterial carbon dioxide pressure (paCO2) between the groups were assessed with forward stepwise regression analysis. Biocompatibility was evaluated through measurement of platelet numbers, complement activation products (C3b/c), coagulation (thrombin anti-thrombin III complex), and fibrinolysis (plasmin anti-plasmin complex). No differences were found in oxygen transfer rate per group. However, when correcting the oxygen transfer rate for surface area, group 1 demonstrated a higher oxygen transfer rate compared with group 2 (p < 0.05) at an FiO2 of 40 and 60% and compared with group 3 at an FiO2 of 60 and 70%. The regression analysis showed that the average arterial PO2 was the highest in group 3, i.e., 79.2 mm Hg higher than in group 1 (p < 0.001) and 73.5 mm Hg higher than in group 2 (p < 0.001). Group 3 also had the lowest average arterial pCO2, 0.57 mm Hg lower than in group 1 (p = 0.004) and 0.81 mm Hg lower than in group 2 (p < 0.001). During CPB, platelet numbers decreased significantly in all groups (p < 0.001), without differences between the groups. C3b/c levels increased in all groups during CPB. At cessation of CPB the C3b/c level in group 2 (398 nmol/L(-1)) was significantly higher compared to group 1(251 nmol/L(-1); p < 0.05) and group 3 (303 nmol/L(-1); p < 0.05). Thrombin anti-thrombin III complexes and plasmin anti-plasmin complex complexes increased during CPB to significantly high levels at cessation of CPB, but there were no differences between the groups. The oxygenator with the smallest surface area and lowest priming volume (group 1) had the highest oxygen transfer rate per square meter and showed the least blood damage, as depicted by complement activation. The oxygenator with the largest blood contact surface area and improved geometric configuration (group 3) showed the lowest oxygen transfer rate per square meter. However, this oxygenator elevated oxygen partial pressure the most and reduced carbon dioxide partial pressure the most. In group 2, where...

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Heparin surface treatment does not impair gas and heat transfer of an extracorporeal circuit

Cited by 4 publications

References 6 publications

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Oxygen-transfer performance of a newly designed, very low-volume membrane oxygenator

Comparison of Three Commercially Available Hollow Fiber Oxygenators: Gas Transfer Performance and Biocompatibility

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