Pump-induced haemolysis: a comparison of short-term ventricular assist devices

Abstract

Centrifugal pumps are superior to roller pumps for extended support durations in terms of pump-induced haemolysis. In this study, we evaluated the commonly used Biomedicus BP 50 and compared it with the Jostra Rotaflow and a standard roller pump in an in vitro test circuit. Each circuit was run for a six-day period and repeated five times. Plasma haemoglobin values showed the roller pump to become more haemolytic than the Biomedicus (p = 0.022) and the Rotaflow. A statistically significant difference between the Biomedicus and the Rotaflow was observed on day six of the trial (p = 0.016), with the Rotaflow showing lower levels of haemolysis than the Biomedicus. These results support the use of the new generation centrifugal pump, the Rotaflow, as a suitable device for short-term ventricular assist.

Assist devices for circulatory support in therapy-refractory acute heart failure

“…Experimental studies demonstrate that IABP during CLS improves the oxygen supplydemand balance, which supports aforementioned and other clinical observations [53,54 ,55]. ECMO is for short-term use only due to limitations related to hemolysis [56], thrombembolic events [57] etc. In appropriately selected high-risk patients, the rate of survival after initial ECMO support was not different from the survival rate after LVAD support alone [58].…”

Veno-venous extracorporeal membrane oxygenation bridging to pharmacotherapy in pulmonary arterial hypertensive crisis

“…5 Consumptive coagulopathy due to hemolysis in the ECMO circuit results in an increased requirement for blood transfusions with resultant transfusion-related reactions as well as secondary injury to the lungs. 4,6 Complications are reduced by minimizing the duration of mechanical support, meticulously maintaining anticoagulation parameters and platelet counts, and paying close attention to cannula and circuit care to prevent infection, bleeding and thrombus formation. There are few case reports investigating RVADs in decompensated PAH.…”

Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience

“…However, there have been significant advances in perfusion technology since then; polymethylpentene oxygenators [13,14] and centrifugal pumps [15,16] are capable of several weeks of continuous operation with a low incidence of haemolysis, while heparin-coated circuit components cause less systemic inflammation [17,18] and require lower levels of systemic anticoagulation than non-coated circuits.…”