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

Perfusion. 2007 Sep;22(5):323-6. doi: 10.1177/0267659107086270.

Abstract

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.

MeSH terms

  • Anticoagulants / therapeutic use
  • Antithrombin III / therapeutic use
  • Body Size
  • Cardiopulmonary Bypass / adverse effects
  • Cardiopulmonary Bypass / instrumentation*
  • Databases, Factual
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / instrumentation*
  • Female
  • Hemoglobins
  • Hemolysis
  • Humans
  • Infant
  • Infant, Newborn
  • Infusion Pumps*
  • Male
  • Plasma
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Anticoagulants
  • Hemoglobins
  • Antithrombin III