The effect of flow and pressure on the intraoxygenator flow path of different contemporary oxygenators: an in vitro trial

Abstract

Introduction: This study analyzed the effect of different flows and pressures on the intraoxygenator flow path in three contemporary oxygenators and its consequences for oxygen transfer efficiency. Methods: In an experimental setup, intraoxygenator flow path parameters were analyzed at post-oxygenator pressures of 150, 200, and 250 mm Hg and at flows ranging from 2 L/min to the oxygenators’ maximum permitted flow, with and without pulsatility. The oxygen gradient and the oxygen transfer per minute and per 100 mL blood were calculated using previously collected clinical data and compared with the flow path parameters. Results: Increasing pressure did not affect the flow path parameters, whereas pulsatile flow led to significantly increased dynamic oxygenator blood volumes. Increased flow resulted in decreased values of the flow path parameters in all oxygenators, indicating increased flow through short pathways in the oxygenator. In parallel, oxygen transfer/100 mL blood decreased in all oxygenators (average 2.5 ± 0.4 to 2.4 ± 0.3 mL/dL, p > 0.001) and the oxygen gradient increased from 229 ± 45 to 287 ± 29 mm Hg, p > 0.001, indicating decreased oxygen transfer efficiency. Oxygen transfer/min increased (101 ± 15 to 143 ± 20 mL/min/m2, p > 0.001), however, due to the increased flow through the oxygenator. Conclusion: Varying trans-membrane oxygenator pressures did not lead to changes in the intraoxygenator flow path, while an increased flow exhibited lower flow path parameters resulting in less efficient use of the gas exchange compartment. The latter was confirmed by a decrease in O2 transfer efficiency during higher blood flows.

Clinical evaluation of the novel Capiox NX19 adult oxygenator–a multicenter study

“…The mean O 2 gradient (44 ± 19 mmHg/LPM) was similar to values found for Capiox FX25 (45 mmHg/LPM), Inspire 8F (46 mmHg/ LPM) and Quadrox-i (48 mmHg/LPM) at a blood flow rate of six LPM. 17 At a flow rate of four LPM however, Hendrix et al calculated higher mean O 2 gradients of 51 mmHg/LPM for Capiox FX25, 58 mmHg/LPM for Inspire 8F and 53 mmHg/LPM for Quadrox-i. The mean O 2 diffusing capacity of the NX19 (0.38 ± 0.14 mL/min/ mmHg) was lower than that calculated for the Quadrox (0.48 ± 0.09 mL/min/mmHg) in a study by Segers.…”