This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schaadt, J. Search for Related Content PubMed PubMed Citation Articles by Schaadt, J. Social Bookmarking                   What's this?

Oxygenator thrombosis: an international phenomenon

Department of Perfusion, West Roxbury VA Hospital, West Roxbury, Massachusetts, schaadt{at}usw.com

Oxygenator thrombosis, despite adequate anticoagulation, has become a recent concern amongst perfusionists worldwide. The phenomenon is characterized by a transient increase in oxygenator inlet pressure of up to 900 mmHg about 10-15 min after the institution of cardiopulmonary bypass (CPB). Depending on the size and location of the thrombus, shunting may occur that compromises gas transfer to the extent where oxygenator change-out is necessary. This article presents various case reports and publications, both domestic and international, detailing this phenomenon. Research hypothesizes that it is the activation of platelets that subsequently may cause the deposition of fibrin, yielding thrombus formation; however, the primary etiology of this phenomenon remains unknown. Possible catalysts include bypass techniques, equipment selection, pharmacological agents, prime and the patient. This paper will review all of the above with an emphasis on the often overlooked factor - the patient, as there are certain variables in patient hematology that provoke a hypercoagulable state leading to thrombosis, including blood type, genetics, age, disease state, gender and heparin.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				U Da Broi, V Adami, E Falasca, W Malangone, S Crini, and A Degrassi A new oxygenator change-out system and procedure Perfusion, September 1, 2006; 21(5): 297 - 303. [Abstract] [PDF]

				J Dubois, L Jamaer, U Mees, J-L Pauwels, F Briers, J Lehaen, and M Hendrikx Ex vivo evaluation of a new neonatal/infant oxygenator: comparison of the Terumo CAPIOX(R) Baby RX with Dideco Lilliput 1 and Polystan Safe Micro in the piglet model Perfusion, September 1, 2004; 19(5): 315 - 321. [Abstract] [PDF]

				J. Noora, A. Lamy, K. M Smith, R. Kent, D. Batt, J. Fedoryshyn, and X. Wang The effect of oxygenator membranes on blood: a comparison of two oxygenators in open-heart surgery Perfusion, September 1, 2003; 18(5): 313 - 320. [Abstract] [PDF]

				A. R. Fisher, M. Baker, M. Buffin, P. Campbell, S. Hansbro, S. Kennington, A. Lilley, and M. Whitehorne Normal and abnormal trans-oxygenator pressure gradients during cardiopulmonary bypass Perfusion, January 1, 2003; 18(1): 25 - 30. [Abstract] [PDF]

				R C Groom, R J Forest, J E Cormack, K S Niimi, and J Morton Parallel replacement of the oxygenator that is not transferring oxygen: the PRONTO procedure Perfusion, December 1, 2002; 17(6): 447 - 450. [Abstract] [PDF]

				G J Myers, J F Legare, J A Sullivan, R B Leadon, R Johnstone, W Swyer, C Squires, C Power, and G M Hirsch Use of autologous blood as part of the perfusate for cardiopulmonary bypass: a priming technique Perfusion, May 1, 2002; 17(3): 211 - 216. [Abstract] [PDF]

				H. P Wendel, A. Philipp, N. Weber, D. E Birnbaum, and G. Ziemer Oxygenator thrombosis: worst case after development of an abnormal pressure gradient - incidence and pathway Perfusion, July 1, 2001; 16(4): 271 - 278. [Abstract] [PDF]

				P A. Segers, J F Heida, I de Vries, C Maas, A J Boogaart, and S Eilander Clinical evaluation of nine hollow-fibre membrane oxygenators Perfusion, March 1, 2001; 16(2): 95 - 106. [Abstract] [PDF]

				A. Liebold, C.M. Reng, A. Philipp, M. Pfeifer, and D.E. Birnbaum Pumpless extracorporeal lung assist - experience with the first 20 cases Eur. J. Cardiothorac. Surg., May 1, 2000; 17(5): 608 - 613. [Abstract] [Full Text] [PDF]