Comparison of hollow-fiber membrane oxygenators with different perfusion modes during normothermic and hypothermic CPB in a simulated neonatal model

Akif Undar, Bingyang Ji, Branka Lukic, Conrad M. Zapanta, Allen Kunselman, John D. Reibson, Tigran Khalapyan, Larry Baer, William Weiss, Gerson Rosenberg, John Myers

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: The objectives of this investigation were (1) to compare two hollow-fiber membrane oxygenators (Capiox Baby RX versus Lilliput 1-D901) in terms of pressure drops and surplus hemodynamic energy (SHE) during normothermic and hypothermic cardiopulmonary bypass (CPB) in a simulated neonatal model; and (2) to evaluate pulsatile and non-pulsatile perfusion modes for each oxygenator in terms of SHE levels. Methods: In a simulated patient, CPB was initiated at a constant pump flow rate of 500 mL/min. The circuit was primed with fresh bovine blood. After 5 min of normothermic CPB, the pseudo-patient was cooled down to 25°C for 10 min followed by 30 min of hypothermic CPB. The pseudopatient then underwent 10 min of rewarming and 5 min of normothermic CPB. At each experimental site (pre- and post-oxygenator and pre-aortic cannula), SHE was calculated using the following formula {SHE (ergs/cm3)=1332 [((∫fpdt)/(∫fdt))-mean arterial pressure]} (f = pump flow and p = pressure). A linear mixed-effects model that accounts for the correlation among repeated measurements was fit to the data to assess differences in SHE between oxygenators, pumps, and sites. Tukey's multiple comparison procedure was used to adjust p-values for post-hoc pairwise comparisons. Results: The pressure drops in the Capiox group compared to the Lilliput group were significantly lower during hypothermic non-pulsatile (21.3±0.5 versus 50.7±0.9 mmHg, p < 0.001) and pulsatile (22 ± 0.0 versus 53.3 ± 0.5 mmHg, p < 0.001) perfusion, respectively. Surplus hemodynamic energy levels were significantly higher in the pulsatile group compared to the non-pulsatile group, with Capiox (1655 ± 92 versus 10 008 ± 1370 ergs/cm3, p <0.001) or Lilliput (1506±112 versus 7531±483 ergs/cm3, p <0.001) oxygenators. During normothermic CPB, both oxygenators had patterns similar to those observed under hypothermic conditions. Conclusions: The Capiox oxygenator had a significantly lower pressure drop in both pulsatile and non-pulsatile perfusion modes. For each oxygenator, the SHE levels were significantly higher in the pulsatile mode.

Original languageEnglish (US)
Pages (from-to)381-390
Number of pages10
JournalPerfusion
Volume21
Issue number6
DOIs
StatePublished - Dec 1 2006

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Oxygenators
Membrane Oxygenators
Cardiopulmonary Bypass
Hemodynamics
Perfusion
Membranes
energy
Fibers
Pressure
Electron energy levels
Pressure drop
Pumps
Group
Rewarming
baby
Arterial Pressure
Blood
Flow rate

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

@article{cafa15233ec6420db966dcca06afc3e3,
title = "Comparison of hollow-fiber membrane oxygenators with different perfusion modes during normothermic and hypothermic CPB in a simulated neonatal model",
abstract = "Purpose: The objectives of this investigation were (1) to compare two hollow-fiber membrane oxygenators (Capiox Baby RX versus Lilliput 1-D901) in terms of pressure drops and surplus hemodynamic energy (SHE) during normothermic and hypothermic cardiopulmonary bypass (CPB) in a simulated neonatal model; and (2) to evaluate pulsatile and non-pulsatile perfusion modes for each oxygenator in terms of SHE levels. Methods: In a simulated patient, CPB was initiated at a constant pump flow rate of 500 mL/min. The circuit was primed with fresh bovine blood. After 5 min of normothermic CPB, the pseudo-patient was cooled down to 25°C for 10 min followed by 30 min of hypothermic CPB. The pseudopatient then underwent 10 min of rewarming and 5 min of normothermic CPB. At each experimental site (pre- and post-oxygenator and pre-aortic cannula), SHE was calculated using the following formula {SHE (ergs/cm3)=1332 [((∫fpdt)/(∫fdt))-mean arterial pressure]} (f = pump flow and p = pressure). A linear mixed-effects model that accounts for the correlation among repeated measurements was fit to the data to assess differences in SHE between oxygenators, pumps, and sites. Tukey's multiple comparison procedure was used to adjust p-values for post-hoc pairwise comparisons. Results: The pressure drops in the Capiox group compared to the Lilliput group were significantly lower during hypothermic non-pulsatile (21.3±0.5 versus 50.7±0.9 mmHg, p < 0.001) and pulsatile (22 ± 0.0 versus 53.3 ± 0.5 mmHg, p < 0.001) perfusion, respectively. Surplus hemodynamic energy levels were significantly higher in the pulsatile group compared to the non-pulsatile group, with Capiox (1655 ± 92 versus 10 008 ± 1370 ergs/cm3, p <0.001) or Lilliput (1506±112 versus 7531±483 ergs/cm3, p <0.001) oxygenators. During normothermic CPB, both oxygenators had patterns similar to those observed under hypothermic conditions. Conclusions: The Capiox oxygenator had a significantly lower pressure drop in both pulsatile and non-pulsatile perfusion modes. For each oxygenator, the SHE levels were significantly higher in the pulsatile mode.",
author = "Akif Undar and Bingyang Ji and Branka Lukic and Zapanta, {Conrad M.} and Allen Kunselman and Reibson, {John D.} and Tigran Khalapyan and Larry Baer and William Weiss and Gerson Rosenberg and John Myers",
year = "2006",
month = "12",
day = "1",
doi = "10.1177/0267659106073996",
language = "English (US)",
volume = "21",
pages = "381--390",
journal = "Perfusion",
issn = "0267-6591",
publisher = "SAGE Publications Ltd",
number = "6",

}

Comparison of hollow-fiber membrane oxygenators with different perfusion modes during normothermic and hypothermic CPB in a simulated neonatal model. / Undar, Akif; Ji, Bingyang; Lukic, Branka; Zapanta, Conrad M.; Kunselman, Allen; Reibson, John D.; Khalapyan, Tigran; Baer, Larry; Weiss, William; Rosenberg, Gerson; Myers, John.

In: Perfusion, Vol. 21, No. 6, 01.12.2006, p. 381-390.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of hollow-fiber membrane oxygenators with different perfusion modes during normothermic and hypothermic CPB in a simulated neonatal model

AU - Undar, Akif

AU - Ji, Bingyang

AU - Lukic, Branka

AU - Zapanta, Conrad M.

AU - Kunselman, Allen

AU - Reibson, John D.

AU - Khalapyan, Tigran

AU - Baer, Larry

AU - Weiss, William

AU - Rosenberg, Gerson

AU - Myers, John

PY - 2006/12/1

Y1 - 2006/12/1

N2 - Purpose: The objectives of this investigation were (1) to compare two hollow-fiber membrane oxygenators (Capiox Baby RX versus Lilliput 1-D901) in terms of pressure drops and surplus hemodynamic energy (SHE) during normothermic and hypothermic cardiopulmonary bypass (CPB) in a simulated neonatal model; and (2) to evaluate pulsatile and non-pulsatile perfusion modes for each oxygenator in terms of SHE levels. Methods: In a simulated patient, CPB was initiated at a constant pump flow rate of 500 mL/min. The circuit was primed with fresh bovine blood. After 5 min of normothermic CPB, the pseudo-patient was cooled down to 25°C for 10 min followed by 30 min of hypothermic CPB. The pseudopatient then underwent 10 min of rewarming and 5 min of normothermic CPB. At each experimental site (pre- and post-oxygenator and pre-aortic cannula), SHE was calculated using the following formula {SHE (ergs/cm3)=1332 [((∫fpdt)/(∫fdt))-mean arterial pressure]} (f = pump flow and p = pressure). A linear mixed-effects model that accounts for the correlation among repeated measurements was fit to the data to assess differences in SHE between oxygenators, pumps, and sites. Tukey's multiple comparison procedure was used to adjust p-values for post-hoc pairwise comparisons. Results: The pressure drops in the Capiox group compared to the Lilliput group were significantly lower during hypothermic non-pulsatile (21.3±0.5 versus 50.7±0.9 mmHg, p < 0.001) and pulsatile (22 ± 0.0 versus 53.3 ± 0.5 mmHg, p < 0.001) perfusion, respectively. Surplus hemodynamic energy levels were significantly higher in the pulsatile group compared to the non-pulsatile group, with Capiox (1655 ± 92 versus 10 008 ± 1370 ergs/cm3, p <0.001) or Lilliput (1506±112 versus 7531±483 ergs/cm3, p <0.001) oxygenators. During normothermic CPB, both oxygenators had patterns similar to those observed under hypothermic conditions. Conclusions: The Capiox oxygenator had a significantly lower pressure drop in both pulsatile and non-pulsatile perfusion modes. For each oxygenator, the SHE levels were significantly higher in the pulsatile mode.

AB - Purpose: The objectives of this investigation were (1) to compare two hollow-fiber membrane oxygenators (Capiox Baby RX versus Lilliput 1-D901) in terms of pressure drops and surplus hemodynamic energy (SHE) during normothermic and hypothermic cardiopulmonary bypass (CPB) in a simulated neonatal model; and (2) to evaluate pulsatile and non-pulsatile perfusion modes for each oxygenator in terms of SHE levels. Methods: In a simulated patient, CPB was initiated at a constant pump flow rate of 500 mL/min. The circuit was primed with fresh bovine blood. After 5 min of normothermic CPB, the pseudo-patient was cooled down to 25°C for 10 min followed by 30 min of hypothermic CPB. The pseudopatient then underwent 10 min of rewarming and 5 min of normothermic CPB. At each experimental site (pre- and post-oxygenator and pre-aortic cannula), SHE was calculated using the following formula {SHE (ergs/cm3)=1332 [((∫fpdt)/(∫fdt))-mean arterial pressure]} (f = pump flow and p = pressure). A linear mixed-effects model that accounts for the correlation among repeated measurements was fit to the data to assess differences in SHE between oxygenators, pumps, and sites. Tukey's multiple comparison procedure was used to adjust p-values for post-hoc pairwise comparisons. Results: The pressure drops in the Capiox group compared to the Lilliput group were significantly lower during hypothermic non-pulsatile (21.3±0.5 versus 50.7±0.9 mmHg, p < 0.001) and pulsatile (22 ± 0.0 versus 53.3 ± 0.5 mmHg, p < 0.001) perfusion, respectively. Surplus hemodynamic energy levels were significantly higher in the pulsatile group compared to the non-pulsatile group, with Capiox (1655 ± 92 versus 10 008 ± 1370 ergs/cm3, p <0.001) or Lilliput (1506±112 versus 7531±483 ergs/cm3, p <0.001) oxygenators. During normothermic CPB, both oxygenators had patterns similar to those observed under hypothermic conditions. Conclusions: The Capiox oxygenator had a significantly lower pressure drop in both pulsatile and non-pulsatile perfusion modes. For each oxygenator, the SHE levels were significantly higher in the pulsatile mode.

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U2 - 10.1177/0267659106073996

DO - 10.1177/0267659106073996

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AN - SCOPUS:33846859586

VL - 21

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JO - Perfusion

JF - Perfusion

SN - 0267-6591

IS - 6

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