Technical Aspects of Plasma Leakage Prevention in Microporous Capillary Membrane Oxygenators

Mottaghy, K.; Oedekoven, B.; Starmans, H.; Müller, Bernd R.; Kashefi, Ali; Hoffmann, Bernd; Böhm, Stephan H.

doi:10.1097/00002480-198907000-00154

Cited by 35 publications

(12 citation statements)

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“…Plasma leakage is primarily related to lipoprotein adsorption on the membrane surface. 1,2 Once plasma leakage occurs, the gas transfer performance can drastically diminish, and the device may fail or require replacement. In addition, gas microbubbles can leak into the blood under certain conditions.…”

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confidence: 99%

A Polymethylpentene Fiber Gas Exchanger for Long-Term Extracorporeal Life Support

et al. 2005

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A polymethylpentene (PMP) fiber gas exchange device was evaluated in healthy sheep (35-42 kg) to characterize its performance and potential use in clinical extracorporeal life support (ECLS). Five PMP devices (1.3 m2) were compared with five silicone rubber membrane lung (SRML) devices (1.5 m2) that were supported on venovenous ECLS for 72 hours. The two device groups were compared for differences in gas exchange, device pressure gradient, hematology, blood biochemistry, and pathology. The results showed superiority in the PMP devices in both oxygen and CO2 exchange when compared at similar blood flow rates. Platelet consumption and the device pressure gradient were significantly less when using the PMP device. The device pressure gradient across the PMP devices was < 20 mm Hg as compared with > 150 mm Hg for the SRML devices at all blood flow rates. Changes in plasma hemoglobin levels, leukocyte counts, blood chemistry results, and pathologic findings were not significantly different between the two device groups. Plasma leakage or device failure did not occur in any of the test devices. These data support the use of the PMP device for extended circulatory support. Patients may fare better because of improved preservation of platelets, and the low resistance may allow for wider use of centrifugal-style pumps or the use of the device in a pumpless arteriovenous mode.

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confidence: 99%

A Polymethylpentene Fiber Gas Exchanger for Long-Term Extracorporeal Life Support

et al. 2005

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“…The focus of this study was on the pressure and hemodynamic energy changes across the oxygenator, but did not take into account other variables that could play a factor in its performance. Future studies may investigate differences in oxygen transfer among different brands, such as differences in plasma leakage or the accumulation of cellular material on the membrane surface (16).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Perfusion Quality in Hollow‐Fiber Membrane Oxygenators for Neonatal Extracorporeal Life Support

et al. 2010

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Perfusion quality is an important issue in extracorporeal life support (ECLS); without adequate perfusion of the brain and other vital organs, multiorgan dysfunction and other deficits can result. The authors tested three different pediatric oxygenators (Medos Hilite 800 LT, Medtronic Minimax Plus, and Capiox Baby RX) to determine which gives the highest quality of perfusion at flow rates of 400, 600, and 800 mL/min using human blood (36 degrees C, 40% hematocrit) under both nonpulsatile and pulsatile flow conditions. Clinically identical equipment and a pseudo-patient were used to mimic operating conditions during neonatal ECLS. Traditionally, the postoxygenator surplus hemodynamic energy value (SHE(post), extra energy obtained through pulsatile flow) is the one relied upon to give a qualitative determination of the amount of perfusion in the patient; the authors also examined SHE retention through the membrane, as well as the contribution of SHE(post) to the postoxygenator total hemodynamic energy (THE(post)). At each experimental condition, pulsatile flow outperformed nonpulsatile flow for all factors contributing to perfusion quality: the SHE(post) values for pulsatile flow were 4.6-7.6 times greater than for nonpulsatile flow, while the THE(post) remained nearly constant for pulsatile versus nonpulsatile flow. For both pulsatile and nonpulsatile flow, the Capiox Baby RX oxygenator was found to deliver the highest quality of perfusion, while the Minimax Plus oxygenator delivered the least perfusion. It is the authors' recommendation that the Baby RX oxygenator running under pulsatile flow conditions be used for pediatric ECLS, but further studies need to be done in order to establish its effectiveness beyond the FDA-approved time span.

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“…The liquid–gas interface migrates during time into the membrane, starting from the blood side, up to the gas face of the membrane; the migration starts when the pressure difference between the two bulk fluids equals the so‐called breakthrough pressure, derived from the Young–Laplace law

Δ p_{italicBT} = p_{G} - p_{B} = \frac{2 \cdot σ \cdot c o s (italicθ)}{r}

where σ is the gas/blood surface tension, θ is the contact angle of the material with respect to the blood and the gaseous phase, p B is the bulk blood phase pressure, p G is the bulk gas phase pressure, and r is the mean pore radius. The breakthrough pressure Δ p BT represents the minimal pressure difference required to avoid membrane leakage.…”

Section: Theorymentioning

confidence: 99%

Extracorporeal membrane blood oxygenators: effect of membrane wetting on gas transfer and device performance

Paola

Terrinoni

Vitale

2012

Asia-Pacific J Chem Eng

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Hollow fiber contactors are successfully used as blood oxygenators in extracorporeal membrane oxygenation (ECMO); the optimization of these devices relies on a full comprehension of transport mechanisms involving respiratory gasses. This phenomenon is not clearly understood although it strongly affects blood oxygenators' performance. This work presents a model for countercorrent ECMO oxygenators, accounting for both membrane wetting and chemical reactions occurring in these systems. In the first part of the paper, the theoretical framework is presented; later, membrane wetting is analyzed and it is shown its effect on the overall mass transfer coefficients. Namely, it comes to light that membrane wetting strongly reduces membrane performances in terms of gasses transport and of respiratory quotient. Copyright © 2012 Curtin University of Technology and John Wiley & Sons, Ltd.

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Technical Aspects of Plasma Leakage Prevention in Microporous Capillary Membrane Oxygenators

Cited by 35 publications

References 0 publications

A Polymethylpentene Fiber Gas Exchanger for Long-Term Extracorporeal Life Support

A Polymethylpentene Fiber Gas Exchanger for Long-Term Extracorporeal Life Support

Comparison of Perfusion Quality in Hollow‐Fiber Membrane Oxygenators for Neonatal Extracorporeal Life Support

Extracorporeal membrane blood oxygenators: effect of membrane wetting on gas transfer and device performance

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