Insensible Water Loss From the Medtronic Minimax Oxygenator: An In Vitro Study

Alexander, Plato; Lawson, D. Scott; Cornell, Jack; Craig, Damian M.; Cheifetz, Ira M.

doi:10.1097/01.mat.0000202275.72712.47

Cited by 7 publications

(20 citation statements)

References 9 publications

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“…Our data are similar to data from the Camacho, et al study, suggesting that membrane types without micro-porous surfaces yield a somewhat lower insensible water loss value than that of micro-porous membrane oxygenators ( Figure 3). 6,12,13 In conclusion, the Jostra Quadrox D oxygenator has lower insensible water loss per liter of sweep gas than other types of oxygenators described in the recent literature. This study provides useful data for management of fluid balance in patients of all sizes who need ECMO support in the critical care setting.…”

Section: Discussionmentioning

confidence: 85%

“…This study found that this oxygenator lost 82.7 ml of free water per day per liter of sweep gas via evaporation. 6 This study also showed a constant linear proportionality between time, evaporative loss, and sodium. The mean sodium increase was reported to be 5.5 mEq/day per liter of sweep gas used.…”

Section: Discussionmentioning

confidence: 86%

“…This study was designed to duplicate the methods used by Alexander, et al done at this institution in 2006. 6 The authors, however, did not duplicate the initial 72 hour run nor attempt to collect sodium data described by Alexander. The authors believe that the study done in 2006 proved that water loss from an oxygenator is linear over extended time periods and that sodium values will rise as a result of the water loss.…”

Section: Discussionmentioning

confidence: 99%

“…We sought to quantify the insensible water loss from the Quadrox D by using an in vitro technique that has already been validated and published by others in the literature. 6,12,13 The phenomenon of water transmission across a polyurethane membrane has been theorized to be governed by a combination of diffusion and convection. 14 Fick's first law describes diffusion as a mechanism that varies directly with the size of the difference between the water vapor concentrations on either surface of the membrane.…”

Section: Discussionmentioning

confidence: 99%

“…Hypernatremia can result from untreated insensible water loss, leading to possible cerebral complications. 6,7 A survey in 2002 showed the start of a trend towards the use of hollow-fiber oxygenators in the neonatal ECMO setting. 8 At that time, the only hollow-fiber oxygenators available in the United States of America (US) were micro-porous polypropylene hollow-fiber oxygenators.…”

Section: Introductionmentioning

confidence: 99%

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Insensible water loss from the Jostra Quadrox D oxygenator: an in vitro study

Lawson

Holt

2007

Perfusion

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Extracorporeal membrane oxygenation (ECMO) has been shown to improve outcomes in neonatal patients with respiratory and/or cardiac failure. Insensible water loss is defined as water loss via evaporation from the skin and respiration. Fluid and electrolyte balance are a primary concern and very challenging in the neonatal patient population. Hypernatremia can result from untreated insensible water loss, leading to possible cerebral complications. A new type of fiber used in the Jostra Quadrox D oxygenator has recently been approved for use in the United States of America. This oxygenator uses a polymethylpentene closed hollow-fiber technology and has been approved for six hours of continuous use by the Federal Drug Administration. The closed hollow-fiber technology may be advantageous for extended use due to the fact that it is a true membrane and plasma leakage will not occur across its surface. The Jostra Quadrox D is an adult-sized oxygenator with a surface area of 1.8 M(2). The aim of this study is to discover what the insensible water loss will be from the Jostra Quadrox D when used at blood flows which would mimic those used for a neonatal ECMO patient. The median insensible water loss from the Quadrox D oxygenator at a gas flow rate of two liters per minute(LPM) was 4.0 +/- 0.2 ml/hour, at five LPM was 9.8 +/- 0.4 ml/hour and at 10 LPM was 20.6 +/- 0.7 ml/hour. The daily evaporative water loss from the Jostra Quadrox D can be estimated to be 48.0 +/- 2.1 ml for each LPM of sweep gas with a normal saline pump flow rate of 500 ml/min.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Insensible water loss from the Jostra Quadrox D oxygenator: an in vitro study

Lawson

Holt

2007

Perfusion

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Influence of the ECMO circuit on the concentration of nutritional supplements

Lindberg

Videm

Dahl

et al. 2020

Sci Rep

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Circulating compounds such as drugs and nutritional components might adhere to the oxygenator fibers and tubing during ECMO support. This study evaluated the amount of nutritional supplements adsorbed to the ECMO circuit under controlled ex vivo conditions. Six identical ECMO circuits were primed with fresh human whole blood and maintained under physiological conditions at 36 °C for 24 h. A dose of nutritional supplement calculated for a 70 kg patient was added. 150 mL volume was drawn from the priming bag for control samples and kept under similar conditions. Blood samples were obtained at predetermined time points and analyzed for concentrations of vitamins, minerals, lipids, and proteins. Data were analyzed using mixed models with robust standard errors. No significant differences were found between the ECMO circuits and the controls for any of the measured variables: cobalamin, folate, vitamin A, glucose, minerals, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides or total proteins. There was an initial decrease and then an increase in the concentration of cobalamin and folate. Vitamin A concentrations decreased in both groups over time. There was a decrease in concentration of glucose and an increased concentration of lactate dehydrogenase over time in both groups. There were no significant alterations in the concentrations of nutritional supplements in an ex vivo ECMO circuit compared to control samples. The time span of this study was limited, thus, clinical studies over a longer period of time are needed.

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Insensible Water Loss Through Adult Extracorporeal Membrane Oxygenation Circuit

Yan²,

Arthur³

et al. 2014

ASAIO Journal

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Patients on extracorporeal membrane oxygenation (ECMO) are critically ill, and fluid balance need to be managed as accurately as possible. Previous studies have focused on insensible water loss through neonatal ECMO circuit and showed that water loss through the ECMO circuit was correlated with the sweep-gas flow rates. Current study is the first study focusing on insensible water loss through adult ECMO circuit. An in vitro extracorporeal circuit consisting of Jostra Quadrox D membrane oxygenator and centrifugal pump was primed with normal saline. The amount of water loss through the ECMO circuit was found to be linearly correlated with the sweep-gas flow rate and fluid temperature. For every liter per minute of sweep-gas flow at 37°C, 0.046 ml/min of water will be lost, and for every change of fluid temperature by 1°C, water content loss will be changed by 0.0026 ml/min by multiple linear regression (R = 0.996). The average daily water loss for every liter per minute of sweep-gas flow at 33, 34, 35, 36, 37, 38, and 39°C were 51.3, 55, 58.8, 62.5, 66.2, 70.0, and 73.7 ml/day, respectively.

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Insensible Water Loss From the Medtronic Minimax Oxygenator: An In Vitro Study

Cited by 7 publications

References 9 publications

Insensible water loss from the Jostra Quadrox D oxygenator: an in vitro study

Insensible water loss from the Jostra Quadrox D oxygenator: an in vitro study

Influence of the ECMO circuit on the concentration of nutritional supplements

Insensible Water Loss Through Adult Extracorporeal Membrane Oxygenation Circuit

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