Pulse conductance and flow-induced hemolysis during pulsatile cardiopulmonary bypass.

Abstract:

:In this study, the hypothesis was tested that a low-resistant, high-compliant oxygenator provides better pulse conductance and less hemolysis than a high-resistant, low-compliant oxygenator during pulsatile cardiopulmonary bypass. Forty adults undergoing coronary artery bypass surgery were randomly divided into two groups using either an oxygenator with a relatively low hydraulic resistance (Quadrox BE-HMO 2000, Maquet Cardiopulmonary AG, Hirrlingen, Germany) or with a relatively high hydraulic resistance (Capiox SX18, Terumo Cardiovascular Systems, Tokyo, Japan). The phase shift between the flow signals measured at the inlet and outlet of the oxygenator was used to assess compliance. Pulse conductance in terms of pressure attenuation was calculated by dividing the outlet pulse pressure of the oxygenator by the inlet pulse pressure. A normalized index was used to assess hemolysis. The phase shifts in time of the flow pulses were 36 +/- 6 ms in the low-resistant (high-compliant) oxygenator, and 14 +/- 2 ms in the high-resistant (low-compliant) oxygenator group (P < 0.001). The low-resistant, high-compliant oxygenator provided 27% better pulse conductance compared with the high-resistant, low-compliant oxygenator (0.84 +/- 0.02 and 0.66 +/- 0.01, respectively, P < 0.001). Inlet pulse pressures were significantly higher (29%) in the high-resistant, low-compliant (Capiox) group than in the low-resistant, high-compliant (Quadrox) group (838 +/- 38 mm Hg and 648 +/- 25 mm Hg respectively, P < 0.001), but no significant difference in hemolysis was found. A low-resistant, high-compliant oxygenator provides better pulse conduction than a high-resistant, low-compliant oxygenator. However, the study data could not confirm the association of high pressures with increased hemolysis.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Simons AP,Wortel P,van Kan RA,van der Veen FH,Weerwind PW,Maessen JG

doi

10.1111/j.1525-1594.2009.00853.x

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

289-94

issue

4

eissn

0160-564X

issn

1525-1594

pii

AOR853

journal_volume

34

pub_type

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