scholarly journals Some advantages of the membrane oxygenator for open-heart surgery

1975 ◽  
Vol 69 (6) ◽  
pp. 884-890 ◽  
Author(s):  
J.S. Wright ◽  
G.C. Fisk ◽  
T.A. Torda ◽  
R.B. Stacey ◽  
R.G. Hicks
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Membrane Oxygenator

scholarly journals Cerebral Effects of Circulatory Arrest at 20° C in the Infant Pig

1974 ◽  
Vol 2 (1) ◽  
pp. 33-42 ◽  
Author(s):  
G. C. Fisk ◽  
J. S. Wright ◽  
B. B. Turner ◽  
W. de C. Baker ◽  
R. G. Hicks ◽  
...  
Keyword(s):  
Brain Damage ◽  
Heart Surgery ◽  
Circulatory Arrest ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Membrane Oxygenator ◽  
Perfusion System ◽  
Experimental Procedure ◽  
Hypothermic Arrest ◽  
Continuous Perfusion

Circulatory arrest at 20° C is used during open heart surgery in infants. It has been stated that significant brain damage does not occur. Piglets between two and six weeks of age were cooled to 20° C using extracorporeal circulation and a membrane oxygenator. After one hour of circulatory arrest the perfusion system was used to rewarm the animals and restore normal circulation. Electroencephalogram was monitored throughout perfusion and surgery, and repeated on surviving animals on the third, fifth, seventh and tenth postoperative days. On the tenth day the animals were killed by injection of pentobarbitone. Other groups were subjected to Continuous perfusion at 20° C, Continuous perfusion at 37° C, Thoracotomy and cannulation, Ischaemia, and Hypoxia. The return of E.E.G. activity was delayed after circulatory arrest compared with those continuously perfused. Lesions were found in the cerebral cortex in all the animals which had circulatory arrest and those subjected to ischaemia and hypoxia. The brains of animals of the other groups were indistinguishable from those killed without any experimental procedure. Despite apparent recovery, brain damage following hypothermic arrest during open heart surgery remains possible.

EXPERIENCE WITH A MEMBRANE OXYGENATOR FOR OPEN‐HEART SURGERY IN INFANTS AND CHILDREN

1972 ◽  
Vol 2 (17) ◽  
pp. 932-934 ◽  
Author(s):  
G. C. Fisk ◽  
J. S. Wright ◽  
R. B. Stacey ◽  
D. A. Horton ◽  
J. C. Lawrence ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Infants And Children ◽  
Open Heart ◽  
Membrane Oxygenator ◽  
In Infants And Children

A clinical evaluation of the performance characteristics of one membrane and five bubble oxygenators: gas transfer and gaseous microemboli production

Perfusion ◽  
1986 ◽  
Vol 1 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Derek T Pearson ◽  
Michael P Holden ◽  
Stefan J Poslad ◽  
Alan Murray ◽  
Philip S Waterhouse
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
The Other ◽  
Gas Transfer ◽  
Arterial Line ◽  
Open Heart ◽  
Blood Gas ◽  
Membrane Oxygenator ◽  
Normal Range ◽  
Meaningful Data

The gas transfer characteristics and gaseous microemboli (GME) production of five different bubble oxygenators (Polystan Venotherm, Harvey H-1700, Bentley BIO-10, Gambro 10 and Shiley S-100A HED) and one membrane oxygenator (Cobe CML) have been assessed during standardized clinical perfusion for open-heart surgery in 60 adult patients. The perfusionist attempted to maintain physiological levels of PaCO 2 (5 ± 1 kPa) and PaO2 (12 ± 2 kPa). Only 3% of blood gas values were within the normal range in the Bentley BIO-10 group compared with 17% for the Gambro 10, 20% for the Shiley S-100A HED, 31% for the Polystan Venotherm, 33% for the Cobe CML and 36% for the Harvey H-1700. The number of GME detected in the arterial line was significantly lower in the Cobe CML membrane oxygenator when compared with any of the five different bubble oxygenators (p < 0·001). The Polystan Venotherm released significantly less GME (p < 0·02) than the other oxygenators and the Shiley S-100A HED released significantly more GME (p < 0·02) than the other oxygenators except the Gambro 10. Low gas-blood flow ratios were not necessarily associated with low GME levels and inadequate oxygenation. This study provides meaningful data on which to base the choice of oxygenator, for clinical perfusions.

scholarly journals Technical Considerations in the Use of the Membrane Oxygenator (Lande'-Edwards) for Open Heart Surgery

1977 ◽  
Vol 5 (2) ◽  
pp. 134-139
Author(s):  
R. B. Stagey ◽  
J. S. Wright ◽  
G. C. Fisk
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Membrane Oxygenator ◽  
Blood Damage ◽  
Cardio Pulmonary Bypass ◽  
Membrane Oxygenators ◽  
Pulmonary Bypass ◽  
Technical Considerations

Experience has shown that successful cardio-pulmonary bypass depends upon an efficient oxygenator which causes minimum blood damage. Experience with 1,600 Lande'-Edwards membrane oxygenators in more than 1,000 patients has led to the development of a simple and safe routine for their use in open heart surgery. The circuitry, method of preparation for perfusion, and management of perfusion are described in detail.

A clinical evaluation of the performance characteristics of one membrane and five bubble oxygenators: haemocompatibility studies

Perfusion ◽  
1986 ◽  
Vol 1 (2) ◽  
pp. 81-98 ◽  
Author(s):  
Derek T Pearson ◽  
Brian McArdle ◽  
Stefan J Poslad ◽  
Alan Murray
Keyword(s):  
Platelet Count ◽  
Platelet Aggregation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Variable Degree ◽  
Open Heart ◽  
Percentage Reduction ◽  
Membrane Oxygenator ◽  
Bubble Oxygenator ◽  
Platelet Depletion

The haemocompatibility of five different bubble oxygenators (Polystan venotherm, Harvey H-1700, Bentley BIO-10, Gambro 10 and Shiley S-100A HED) and one membrane oxygenator (Cobe CML) have been evaluated during standardized clinical perfusion for open-heart surgery in 48 adult patients. Control of arterial PO2 and PCO2 was an important feature of the evaluation protocol. Over the period of cardiopulmonary bypass (CPB) there was a marked difference in the mean percentage reduction in platelet count in the different oxygenator groups. Only 1% reduction in platelet count occurred with the Cobe CML membrane oxygenator group compared with, in the bubble oxygenator groups, 7% for the Gambro 10, 16% for the Harvey H-1700, 19% for the Shiley S-100A HED, 24% for the Bentley BIO-10 and 31% for the Polystan venotherm. The post bypass platelet count was significantly lower than the prebypass value in all oxygenator groups ( p < 0.05) except the Cobe CML and Gambro 10. The two oxygenator groups with the largest percentage reduction in platelet count (Polystan venotherm and Bentley BIO-1 0) demonstrated a significant reduction ( p < 0.05) in platelet aggregation over the period of bypass. Platelet depletion in the Harvey H-1700. Shiley S-100A HED, Bentley BIO-10 and Polystan venotherm oxygenators was associated with a significant fall ( p < 0.05) in mean platelet volume during the first 35 minutes of CPB due to the removal from the circulation of large, young, functionally more active platelets. Erythrocyte damage was minimal in all oxygenator groups and only a minor degree of leucopenia could be demonstrated during the first five minutes of CPB. Cardiotomy suction was not associated with significant changes in platelet numbers or platelet aggregation. When selecting the oxygenator for use in patients undergoing open-heart surgery, gas transfer characteristics and GME production together with the superior preservation of platelet numbers and function in the membrane oxygenator group and variable degree of platelet depletion and reduction in platelet aggregability demonstrated in the five bubble oxygenator groups, must be taken into account.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

Blood Coagulation Studies and Extracorporeal Circulation in Man

1967 ◽  
Vol 18 (03/04) ◽  
pp. 634-646 ◽  
Author(s):  
N Thurnherr
Keyword(s):  
Blood Coagulation ◽  
Extracorporeal Circulation ◽  
Blood Clotting ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Fibrinolytic System ◽  
Open Heart ◽  
Clotting Factors ◽  
Blood Clotting Factors

SummaryBlood clotting investigations have been executed in 25 patients who have undergone open heart surgery with extracorporeal circulation. A description of alterations in the activity of blood clotting factors, the fibrinolytic system, prothrombin consumption and platelets during several phases of the operation is given.

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