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Perfusion
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Evaluation of oxygenators and centrifugal pumps for long-term pediatric extracorporeal membrane oxygenation

A.P.S. Thiara

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway, amrit.thiara{at}rikshospitalet.no

T.N. Hoel

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

F. Kristiansen

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

H.M. Karlsen

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

A.E. Fiane

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

J.L. Svennevig

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

Objective: Two extracorporeal membrane oxygenation (ECMO) circuits for children under 10 kg were evaluated and compared for plasma leakage, hemolysis, blood transfusions, and durability. Methods: Group A (n = 20) was supported by ECMO circuits with the Minimax oxygenator and the Biomedicus centrifugal pump. Group B (n = 10) was supported by ECMO circuits with the Lilliput 2 ECMO oxygenator and the Rotaflow centrifugal pump. Results: ECMO circuit durability, as measured by oxygenator lifespan, was significantly better in Group B than in Group A (p = 0.04). There was significantly lower hemolysis, measured by plasma free hemoglobin, in Group B (p = 0.019), and patients in Group B had significantly less need for antithrombin III transfusion (p = 0.004). No plasma leakage was observed in Group B oxygenators, but plasma leakage was observed in all Group A oxygenators. Conclusion: The combination of a Rotaflow centrifugal pump and Lilliput 2 ECMO oxygenator in pediatric ECMO circuits improved durability and reduced circuit-induced hemolysis. This improvement may be due to the low priming volume, the oxygenator's plasma leakage resistance, the suspended rotor of the centrifugal pump, or a combination of these factors. Perfusion (2007) 22, 323—326.

Perfusion, Vol. 22, No. 5, 323-326 (2007)
DOI: 10.1177/0267659107086270
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A. Thiara, V Hoyland, H Norum, T. Aasmundstad, H. Karlsen, A. Fiane, and O Geiran
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Perfusion, January 1, 2009; 24(1): 45 - 47.
[Abstract] [PDF]