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The Journal of Extra-corporeal... Sep 2013As obesity increases in prevalence, so will cases in which patients present at the boundaries of care. We report the support of a class III obese man, having a body mass...
As obesity increases in prevalence, so will cases in which patients present at the boundaries of care. We report the support of a class III obese man, having a body mass index of 60.8 kg/m2 and in acute renal failure, with a single Trillium-coated Affinity NT Hollow Fiber oxygenator in cardiopulmonary bypass for an emergent aortic valve replacement secondary to infective endocarditis. A maximum oxygen delivery of 807.51 mL of oxygen per minute is reported for this oxygenator in this case report.
Topics: Cardiopulmonary Bypass; Humans; Male; Middle Aged; Obesity, Morbid; Oxygen; Oxygenators
PubMed: 24303600
DOI: No ID Found -
Surgery Oct 1960
Topics: Equipment and Supplies; Humans; Oxygen; Oxygenators; Perfusion; Surgical Procedures, Operative
PubMed: 13685188
DOI: No ID Found -
Journal of Cardiothoracic and Vascular... Feb 1994Present methods for monitoring delivery of ventilating gas to the oxygenator during cardiopulmonary bypass have not been critically examined despite the occurrence of...
Present methods for monitoring delivery of ventilating gas to the oxygenator during cardiopulmonary bypass have not been critically examined despite the occurrence of catastrophic gas flow disturbances. Currently, a flowmeter regulates the delivery of gas into the proximal portion of the gas circuit, and at these institutions, an oxygen (O2) analyzer positioned downstream of the flowmeter monitors oxygen concentration of the flowing gas. However, these devices are incapable of accurately analyzing the flow of gas into the oxygenator housing. In response to this deficiency, the authors developed and evaluated, in a laboratory model, an alternative system for monitoring ventilating gas flow. The system measured quantity of gas flow by pneumotachography, and oxygen concentration of the ventilating gas with a polarographic oxygen analyzer at the gas inlet port of the oxygenator. Five types of disturbances in gas delivery, which have been documented in the medical literature, were created in a laboratory model: (1) O2 concentration variation, (2 and 3) oxygenator gas line disconnection at each of two locations in the gas circuit, (4) a decrease in gas flow to the oxygenator secondary to a leak in the gas circuit, and (5) excess gas flow to the oxygenator. The capability of currently used monitoring devices (flowmeter and "passive" O2 analyzer) with the proposed monitoring system (pneumotachograph and "aspirating" O2 analyzer) was compared for detecting these abnormalities in gas delivery. The currently used devices were only able to satisfactorily detect a change in oxygen concentration. In contrast, the proposed system was able to rapidly detect all types of gas delivery disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Anesthesia, Inhalation; Cardiopulmonary Bypass; Equipment Design; Humans; Isoflurane; Monitoring, Intraoperative; Nebulizers and Vaporizers; Oxygen; Oxygenators; Pressure; Respiration, Artificial; Rheology; Time Factors
PubMed: 8167286
DOI: 10.1016/1053-0770(94)90012-4 -
Perfusion May 2013High-performance, low-prime-volume oxygenators for the pediatric patient population have become a growing market among manufacturers. In the summer of 2011, our... (Clinical Trial)
Clinical Trial
High-performance, low-prime-volume oxygenators for the pediatric patient population have become a growing market among manufacturers. In the summer of 2011, our institution clinically evaluated the performance of the newly released Maquet Quadrox-i Neonatal oxygenator with integrated arterial filter. The static priming volume, including the integrated arterial filter, is 40 ml and the maximum rated blood flow is 1.5 liters per minute (LPM). The device was used on seven pediatric patients, ranging from 3.2 to 14 kg, undergoing various congenital heart defect repairs. Data were collected to calculate gas transfer, trans-oxygenator pressure drop, and heat exchange performance. The mean cardiopulmonary bypass time was 85 minutes and the mean cross-clamp time was 56 minutes. The average oxygen transfer was 34.3 ± 22.8 ml/O2/min and increased with both blood flow and FiO2. The average carbon dioxide transfer was 22.3 ± 17.8 ml/min and increased with both blood flow and gas sweep to blood flow ratio. The average trans-oxygenator pressure drop per blood flow was 53.3 ± 15.5 mmHg/L/min and increased with flow. The average heat exchanger performance factor was 47.6 ± 11.6% and decreased with flow. The heat exchange performance factor at maximum observed clinical flow, 1.42 LPM, was 36.4%. During this evaluation, the Maquet Quadrox-i Neonatal oxygenator adequately performed within its operational flow in the clinical setting.
Topics: Blood Flow Velocity; Blood Pressure; Cardiopulmonary Bypass; Embolic Protection Devices; Female; Humans; Infant, Newborn; Male; Oxygen; Oxygenators, Membrane; Time Factors
PubMed: 23449822
DOI: 10.1177/0267659113475694 -
Perfusion Jan 1992This paper reports a clinical evaluation of Bentley's new Univox membrane oxygenator (Bentley Laboratories, Irvine, California). In this new device, the blood flow path...
This paper reports a clinical evaluation of Bentley's new Univox membrane oxygenator (Bentley Laboratories, Irvine, California). In this new device, the blood flow path is outside the fibre, the incorporated heat exchanger consists of a 22-channel stainless-steel bellows, and the polypropylene fibres are woven into fibre ribbons and wound into each of the bellows channels. In this way, heat and gas transfers take place simultaneously. The priming volume has been reduced to 220ml and the membrane has an effective surface area of 1.6m 2. A BMR 1900 collapsible reservoir (Bentley Laboratories, Irvine, California) was used as a venous reservoir. Ten consenting patients undergoing elective coronary artery bypass surgery were perfused with this new oxygenator. BSA was between 1.7 and 2.11m 2; mean BSA was 1.81. Minimum priming was 1200 ml. The blood-gas results were all within or close to the normal range used in our institution. Acid-base management was performed using alpha-stat regulation and no problems occurred in this series of patients. Average pO 2 was 155mmHG+/-53 with a mean O 2 transfer of 90.7ml and a maximum of 185ml. The heat exchange performance was very good, with a mean coefficient of heat exchange of 0.54+/-0.11 and a maximum of 0.87.
Topics: Aged; Blood Gas Analysis; Coronary Artery Bypass; Equipment Design; Evaluation Studies as Topic; Female; Hot Temperature; Humans; Male; Middle Aged; Oxygen; Oxygenators, Membrane
PubMed: 10147700
DOI: 10.1177/026765919200700109 -
ASAIO Journal (American Society For... 2012For different lung and heart diseases (e.g., acute respiratory distress syndrome, congenital heart failure, and cardiomyopathy) extracorporeal membrane oxygenation is a...
For different lung and heart diseases (e.g., acute respiratory distress syndrome, congenital heart failure, and cardiomyopathy) extracorporeal membrane oxygenation is a well-established therapy, particularly in the field of neonatal and pediatric medicine. To reduce the priming volume of the extracorporeal circuit, different components can be combined. In this study, an oval-shaped oxygenator (called ExMeTrA) with integrated pulsatile pump was tested in vitro using porcine blood. A feasibility study regarding the performance of collapsing and expanding silicone tubes within an oxygenator fiber bundle as a pulsatile pump was previously completed with successful results. The findings of this study improve upon the previous feasibility results, particularly in terms of gas exchange and filling volume. Five modules were manufactured in sizes of 20 ± 2.2 ml (priming volume) with fiber surface areas of 0.24 ± 0.027 m(2) and an analytically calculated volume pumping capacity of 692 ± 75 ml/min. The modules were made of polymethylpentene fibers with dense outer layer to permit long-term applications. The gas exchange rates at a gas/blood flow ratio of 2:1 were between 64 and 72.7 ml(O)(2)/l(blood) and between 62.5 and 81.5 ml/l(blood), depending on the blood flow. The individual module's pumping capacity ranged from 200-500 ml/min thus providing room for further improvements. In order to enhance the pumping capacity while maintaining sufficient gas exchange rates future optimization, adjustments will be made to the inlet and outlet geometries.
Topics: Animals; Blood Flow Velocity; Equipment Design; Extracorporeal Membrane Oxygenation; Heart-Assist Devices; Humans; In Vitro Techniques; Materials Testing; Oxygen; Oxygenators, Membrane; Pediatrics; Respiratory Distress Syndrome; Silicones; Swine
PubMed: 22588146
DOI: 10.1097/MAT.0b013e318251dc70 -
The American Journal of Physiology Aug 1979A small vertical screen oxygenator was built using a stainless steel screen enclosed in a Plexiglas box as the oxygenating surface. The unit was primed with 35 ml...
A small vertical screen oxygenator was built using a stainless steel screen enclosed in a Plexiglas box as the oxygenating surface. The unit was primed with 35 ml dextran-diluted blood (Hct 25.1 +/- 0.6%. mean +/- SE) and tested in cats with a partial cardiopulmonary bypass circuit. An oxygen saturation of more than 95% was always obtained, even when the incoming venous saturation was as low as 15%. The O2 exchange capacity was minimally affected by changes in blood flow (1.5 to 70 ml/min) through the unit. CO2 extraction was not flow limited over the range tested. Output PCO2 was 33.3 +/- 0.6 mmHg and pH was 7.29 +/- 0.02. These results were obtained when 3% CO2 in O2 was passed through the oxygenator chamber at 1.0 to 5.0 l/min. The performance of the unit was stable for periods up to 4 h. The small priming volume and reliable performance make this oxygenator suitable for organ perfusion in small experimental animals.
Topics: Animals; Blood Cell Count; Blood Flow Velocity; Carbon Dioxide; Cats; Hemolysis; Hemoperfusion; Mathematics; Oxygen; Oxygenators
PubMed: 464122
DOI: 10.1152/ajpheart.1979.237.2.H269 -
Transactions - American Society For... 1972
Topics: Animals; Blood Cells; Blood Coagulation Factors; Blood Flow Velocity; Carbon Dioxide; Clinical Enzyme Tests; Extracorporeal Circulation; Heparin; Oximetry; Oxygen; Oxygenators, Membrane; Partial Pressure; Sheep; Silicone Elastomers; Ventilation-Perfusion Ratio
PubMed: 4679890
DOI: No ID Found -
ASAIO Journal (American Society For... 1996The authors developed a new membrane oxygenator that consists of microporous polypropylene hollow fibers coated with a 0.2 micron ultrathin silicone layer. Five...
The authors developed a new membrane oxygenator that consists of microporous polypropylene hollow fibers coated with a 0.2 micron ultrathin silicone layer. Five venoarterial bypasses were conducted on mongrel dogs for 24 hr using these new oxygenators. The blood flow rate was maintained at 750 ml/min, and the V/Q ratio was maintained at 1:1. As a control, three venoarterial bypasses were conducted under the same conditions using an oxygenator with the same design but without the silicone coating. Eight to 16 hr after the initiation of bypass, severe plasma leakage occurred in all control experiments, so the bypasses were terminated. However, plasma leakage did not occur throughout the 24 hr of any of the experiments using the new oxygenator. The O2 transfer rate of the new oxygenators after 24 hr of perfusion was 59.7 +/- 6.6 ml/min/m2, and the plasma free hemoglobin level 8 hr after the initiation of bypass was 41.4 +/- 40.2 mg/dl, compared with 145.3 +/- 189.6 mg/dl in the control group. Scanning electron microscopic examination of the silicone coated fibers after 24 hr of bypass revealed a few scattered platelet adherents and no damage to the silicone coated surface. These results suggest that this new oxygenator has satisfactory gas transfer and good durability.
Topics: Animals; Arteriovenous Shunt, Surgical; Carbon Dioxide; Dogs; Equipment Design; Evaluation Studies as Topic; Extracorporeal Membrane Oxygenation; Hemolysis; Humans; Oxygen; Oxygenators, Membrane; Polypropylenes; Silicones
PubMed: 8944922
DOI: 10.1097/00002480-199609000-00029 -
The Journal of Surgical Research Jan 1973
Topics: Animals; Blood; Carbon Dioxide; Cattle; Extracorporeal Circulation; Filtration; Heart-Lung Machine; Hydrogen-Ion Concentration; Membranes, Artificial; Oxygen; Oxygenators, Membrane; Perfusion; Time Factors
PubMed: 4691731
DOI: 10.1016/0022-4804(73)90010-3