Functional performance of different venous limb options in simulated neonatal/pediatric cardiopulmonary bypass circuits

Luiz Fernando Caneo, Gregory S. Matte, Daniel Peres Guimarães, Guilherme Viotto, Marcelo Mazzeto, Idagene Cestari, Rodolfo A. Neirotti, Marcelo B. Jatene, Shigang Wang, Akif Ündar, João Chang Junior, Fabio B. Jatene

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Abstract

Objective: Hemodilution is a concern in cardiopulmonary bypass (CPB). Using a smaller dual tubing rather than a single larger inner diameter (ID) tubing in the venous limb to decrease prime volume has been a standard practice. The purpose of this study is to evaluate these tubing options. Methods: Four different CPB circuits primed with blood(hematocrit 30%) were investigated. Two setups were used with two circuits for each one. In Setup I, a neonatal oxygenator was connected to dual 3/16” ID venous limbs (Circuit A) or to a single 1/4” ID venous limb (Circuit B); and in Setup II, a pediatric oxygenator was connected to dual 1/4” ID venous limbs (Circuit C) or a single 3/8” ID venous limb (Circuit D). Trials were conducted at arterial flow rates of 500 ml/min up to 1500 ml/ min (Setup I) and up to 3000 ml/min (Setup II), at 36°C and 28°C. Results: Circuit B exhibited a higher venous flow rate than Circuit A, and Circuit D exhibited a higher venous flow rate than Circuit C, at both temperatures. Flow resistance was significantly higher in Circuits A and C than in Circuits B (P<0.001) and D (P<0.001), respectively. Conclusion: A single 1/4” venous limb is better than dual 3/16” venous limbs at all flow rates, up to 1500 ml/min. Moreover, a single 3/8” venous limb is better than dual 1/4” venous limbs, up to 3000 ml/min. Our findings strongly suggest a revision of perfusion practice to include single venous limb circuits for CPB.

Original languageEnglish (US)
Pages (from-to)224-232
Number of pages9
JournalBrazilian Journal of Cardiovascular Surgery
Volume33
Issue number3
DOIs
StatePublished - May 1 2018

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Caneo, L. F., Matte, G. S., Guimarães, D. P., Viotto, G., Mazzeto, M., Cestari, I., Neirotti, R. A., Jatene, M. B., Wang, S., Ündar, A., Chang Junior, J., & Jatene, F. B. (2018). Functional performance of different venous limb options in simulated neonatal/pediatric cardiopulmonary bypass circuits. Brazilian Journal of Cardiovascular Surgery, 33(3), 224-232. https://doi.org/10.21470/1678-9741-2018-0074