Lehle, Karla and Philipp, Alois and Mueller, Thomas and Schettler, Frank and Bein, Thomas and Schmid, Christof and Lubnow, Matthias (2014) Flow Dynamics of Different Adult ECMO Systems: A Clinical Evaluation. ARTIFICIAL ORGANS, 38 (5). pp. 391-398. ISSN 0160-564X, 1525-1594
Full text not available from this repository. (Request a copy)Abstract
Membrane oxygenator (MO) failure is a known hazard during venovenous extracorporeal membrane oxygenation (v-v ECMO) therapy. Knowledge about technical and performance details of different ECMO systems (Maquet, Rastatt, Germany; Medos, Stolberg, Germany; Sorin, Modena, Italy) licensed for adults with acute lung failure might improve their handling. This retrospective study comprises 186 adult patients (Regensburg ECMO Registry) treated with v-v ECMO. Flow dynamic data were used to analyze the performance of different blood pumps, cannula types, and MOs to maintain an adequate blood flow (1-5 L/min). Usage of the Medos ECMO system in critically ill patients required a higher pump speed and generated a higher pressure drop across the MO (dpMO), however, without an increase in free plasma hemoglobin. The dpMO depended on the type of MO and increased with blood flow as expected. Type-specific normal values are reported. A distinct increase in dpMO above normal values within 1 day required an immediate MO exchange. This was an infrequent technical complication (3%). Finally, pressure-flow performance of single dual-lumen cannulas (27 Fr) was comparable with small single-lumen cannulas (15 Fr), without an increased risk of technical-induced hemolysis. Despite different performances, all current commercially available adult v-v ECMO systems produce adequate blood flow without an increased risk in technical-induced hemolysis. Familiarity with the specific properties of individual systems allows early detection of technical complications. Additionally, the choice of an adequate cannula requires a closer consideration of the individual patient situation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRACORPOREAL MEMBRANE-OXYGENATION; RESPIRATORY-FAILURE; LIFE-SUPPORT; BLOOD PUMPS; Oxygenator exchange; Pressure difference; Inflow cannula diameter; Technical-induced hemolysis; Technical complications; Extracorporeal membrane oxygenation; Flow dynamics |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Nov 2019 10:05 |
| Last Modified: | 13 Nov 2019 10:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10259 |
Actions (login required)
 |
View Item |
