Spallation performance of extracorporeal membrane oxygenation tubing

Perfusion ◽  
2000 ◽  
Vol 15 (5) ◽  
pp. 457-466 ◽  
Author(s):  
Giles J Peek ◽  
Andrew Thompson ◽  
Hilliary M Killer ◽  
Richard K Firmin
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Laser Diode ◽  
Weak Correlation ◽  
Roller Pump ◽  
Pump Speed ◽  
Membrane Oxygenation ◽  
Particle Counting ◽  
Tygon Tubing ◽  
On Line ◽  
Over Time

During the prolonged roller pump use of extracorporeal membrane oxygenation (ECMO), tubing wear generates spallation. The spallation performance of Tygon® S-65-HL was measured and compared with a potential new ECMO tubing, LVA (Portex 800-500-575). Spallation was measured by on-line laser diode particle counting (HIAC) during simulated ECMO. The effects of differing levels of occlusion and pump speed were examined, as was the effect of spallation over time. The spallation produced by Tygon S-65-HL was less than that seen with LVA during 24 h of simulated ECMO ( p < 0.001), and after 72 h had fallen almost to zero. Spallation with Tygon tubing increases with increasing pump speed and decreases over time. There appears to be only a weak correlation with occlusion, which is surprising. The spallation performance of Tygon S-65-HL was variable and under some conditions exceeded that of LVA. Overall, however, Tygon S-65-HL produced less spallation than LVA. Therefore, LVA cannot be recommended for clinical ECMO use.

scholarly journals Multi-institutional Analysis of 100 Consecutive Patients with COVID-19 and Severe Pulmonary Compromise Treated with Extracorporeal Membrane Oxygenation: Outcomes and Trends Over Time

ASAIO Journal ◽  
2021 ◽  
Vol 67 (5) ◽  
pp. 496-502
Author(s):  
Jeffrey p. Jacobs ◽  
Alfred H. Stammers ◽  
James St. Louis ◽  
J.W. Awori Hayanga ◽  
Michael S. Firstenberg ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Institutional Analysis ◽  
Membrane Oxygenation ◽  
Trends Over Time ◽  
Over Time

A single center’s conversion from roller pump to centrifugal pump technology in extracorporeal membrane oxygenation

Perfusion ◽  
2016 ◽  
Vol 31 (8) ◽  
pp. 662-667 ◽  
Author(s):  
Brandon C. Shade ◽  
Kellie Schiavo ◽  
Tami Rosenthal ◽  
James T Connelly ◽  
Richard W Melchior
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Centrifugal Pump ◽  
Roller Pump ◽  
Membrane Oxygenation

Influence of Extracorporeal Membrane Oxygenation Circuit on Nutritional Supplements

2020 ◽  
Vol 3 (5) ◽  
pp. 01-09
Author(s):  
AS Thiara
Keyword(s):  
Vitamin A ◽  
Extracorporeal Membrane Oxygenation ◽  
Ex Vivo ◽  
Nutritional Supplements ◽  
Ecmo Support ◽  
Blood Pump ◽  
Ecmo Circuit ◽  
Membrane Oxygenation ◽  
Over Time ◽  
Control Samples

Background The main function of extracorporeal membrane oxygenation (ECMO) is to provide systemic perfusion and gas exchange for patients with severe, acute respiratory or cardiac illness. The ECMO system consists of blood pump and a membrane oxygenator. ECMO oxygenator fibers, blood pump and tubing may bind circulating compounds such as drugs and nutritional components during ECMO support. Any loss of vital nutrients due to adsorption to the ECMO circuits may lead to further nutritional debilitation in critical ill patients. Objective The purpose of study is to analyze the amount of nutritional supplements adsorbed to the ECMO circuit under controlled ex vivo conditions Methods Six identical ECMO circuits were primed with fresh human whole blood and maintained under physiological conditions at 36°C for 24 hours. A dose of nutritional supplement calculated for a 70 kg patient was added. 150 mL volume was drawn from priming bag for control samples and kept under similar conditions. Blood samples were obtained at predetermined time points and analyzed for concentrations of vitamins, minerals, lipids, and proteins. Statistical analyses were performed using mixed models with robust standard errors, which allows for repeated samples within each setup and incomplete data. Results No significant differences were found between the ECMO circuits and controls for any of the measured variables: cobalamin, folate, vitamin A, glucose, concentration of minerals, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides, and total proteins. There was an initial decrease and then and increase in the concentration of cobalamin and folate. Vitamin A concentrations decreased in both groups over time. There was a decrease in concentration of glucose and an increased concentration of lactate dehydrogenase over time in both groups. Conclusion There were no changes in the concentrations of nutritional supplements in an ex vivo ECMO circuit compared to control samples, indicating that parenteral nutrition can be given during ECMO support. However, the time span of this study was limited, and the design made it impossible to investigate any functional and structural changes over time in nutritional supplements which lead to diminished effects through the ECMO circuit.

In vitro effects of an extracorporeal membrane oxygenation circuit on the sequestration of ϵ-aminocaproic acid

Perfusion ◽  
2016 ◽  
Vol 32 (3) ◽  
pp. 226-229 ◽  
Author(s):  
Deborah Wagner ◽  
Miguel Caraballo ◽  
John Waldvogel ◽  
Yuki Peterson ◽  
Duxin Sun
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
In Vitro Study ◽  
Aminocaproic Acid ◽  
P Value ◽  
Ecmo Circuit ◽  
Membrane Oxygenation ◽  
Pediatric Dose ◽  
In Vitro Effects ◽  
Over Time

Objective: To assess the in vitro effects of drug sequestration in extracorporeal membrane oxygenation (ECMO) on ϵ-aminocaproic acid (EACA) concentrations. Methods and Design: This in vitro study will determine changes in EACA concentration over time in ECMO circuits. A pediatric dose of 2,500 mg was administered to whole expired blood in the simulated pediatric ECMO circuit. Blood samples were collected at 0, 30, 60, 360 and 1440-minute intervals after initial administration equilibration from three different sites of the circuit: pre-oxygenator (PRE), post-oxygenator (POST) and PVC tubing (PVC) to determine the predominant site of drug loss. The circuit was maintained for two consecutive days with a re-dose at 24 hours to establish a comparison between unsaturated (New) and saturated (Old) oxygenator membranes. Comparisons between sample sites, sample times and New versus Old membranes were statistically analyzed by a linear mixed-effects model with significance defined as a p-value <0.05. Results: There were no significant differences in EACA concentration with respect to sample site, with PRE and POST samples demonstrating respective mean differences of 0.30 mg/ml and 0.34 mg/ml as compared to PVC, resulting in non-significant p-values of 0.373 [95% CI (-0.37, 0.98)] and 0.324 [95% CI (-0.34, 1.01)], respectively. The comparison of New vs. Old ECMO circuits resulted in non-significant changes from baseline, with a mean difference of 0.50 mg/ml, 95% CI (-0.65, 1.65), p=0.315. Conclusion: The findings of this study did not show any significant changes in drug concentration that can be attributed to sequestration within the ECMO circuit. Mean concentrations between ECMO circuit sample sites did not differ significantly. Comparison between New and Old circuits also did not differ significantly in the change from baseline concentration over time. Sequestration within ECMO circuits appears not to be a considerable factor for EACA administration.

Extracorporeal membrane oxygenation–induced fibrinolysis detected by rotational thromboelastometry and treated by oxygenator exchange

Perfusion ◽  
2019 ◽  
Vol 34 (4) ◽  
pp. 330-333 ◽  
Author(s):  
Miroslav Durila ◽  
Tomas Smetak ◽  
Pavel Hedvicak ◽  
Jan Berousek
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Change Over Time ◽  
Rotational Thromboelastometry ◽  
Membrane Oxygenation ◽  
Before And After ◽  
Over Time

Coagulopathy and bleeding is a frequent phenomenon in patients on extracorporeal membrane oxygenation. The cause may be multifactorial and it may change over time. We present a case when bleeding was caused by hyperfibrinolysis induced by oxygenator. The diagnosis was established by comparing thromboelastometry result from blood obtained before and after oxygenator. Hyperfibrinolysis and bleeding could be successfully treated merely by oxygenator exchange.

Extracorporeal Membrane Oxygenation

2019 ◽  
pp. 228-236
Author(s):  
Michael E. Lowe ◽  
Joseph D. Roberts ◽  
Mark A. Chaney
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Disease ◽  
Clinical Efficacy ◽  
Pump System ◽  
Intra Aortic Balloon Pump ◽  
Membrane Oxygenation ◽  
Mechanical Devices ◽  
Over Time

Percutaneous mechanical devices are used in the treatment of severe cardiac or respiratory disease. These devices include extracorporeal membrane oxygenation, intra-aortic balloon pump, TandemHeart™, and Impella®. The use of these devices has increased over time as their clinical efficacy has been established and technological advancements have made their use more practical and accessible. Technological advancements have helped improve the morbidity of ECMO. Two of the major improvements have been to the oxygenator and to the pump system. As these devices become more commonplace, it is important to have a thorough understanding of how each device works, their indications, and potential complications.

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