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Impact of membrane oxygenators on pulsatile versus nonpulsatile perfusion in a neonatal model

Congenital Heart Surgery Service, Texas Children’s Hospital, Houston, Texas, Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas and Department of Surgery, Baylor College of Medicine, Houston, Texas, aundar{at}bcm.tmc.edu

Karl M Koenig

Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas

O H Frazier

Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas

Charles D Fraser, Jr

Congenital Heart Surgery Service, Texas Children’s Hospital, Houston, Texas and Departments of Surgery and Pediatrics, Baylor College of Medicine, Houston, Texas

We investigated the effects of two new hollow-fiber membrane oxygenators, the Capiox SX10 and the Lilliput 901, on pulsatile versus nonpulsatile perfusion in an in vitro model designed to simulate a 3 kg infant. The experiments were divided into eight groups (six pulsatile and two nonpulsatile), according to the equipment and settings used. Each group included six tests. In all experiments, the pseudo-patient’s mean arterial pressure was 40 mmHg, and the pump flow rate was 550 ml/min. During pulsatile cardiopulmonary bypass, the pump’s base flow was set at 30%, and the pump rate was set at 80, 100, 120, 140, or 150 beats/min. The PUMP START and PUMP STOP timing points were adjusted to produce different pulse-width settings. We were especially interested in evaluating the pre- and postoxygenator extracorporeal circuit pressure (ECP), the oxygenator pressure drop, and the precannula ECP.

When used with a pulsatile roller pump, the Capiox produced a significantly lower preoxygenator ECP than the Lilliput (p < 0.001); moreover, the Capiox yielded a significantly lower oxygenator pressure drop (p < 0.001). During nonpulsatile perfusion, the Capiox again produced a lower preoxygenator ECP than the Lilliput (p < 0.001). These results suggest that the Capiox may be more suitable than the Lilliput when the pulsatile flow is employed, and pulsatile flow does not increase the ECP with either oxygenator.

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