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.

Health and well-being of children with congenital cardiac malformations, and their families, following open-heart surgery

2006 ◽  
Vol 16 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Annette Majnemer ◽  
Catherine Limperopoulos ◽  
Michael Shevell ◽  
Charles Rohlicek ◽  
Bernard Rosenblatt ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Well Being ◽  
Psychosocial Health ◽  
Stress Index ◽  
Open Heart ◽  
Normal Range ◽  
Related Quality ◽  
Health Related

Infants who survive open-heart surgery are at risk for developmental disability, which may impact on the well-being not only of the child, but also the family. The objective of our prospective study, therefore, was to determine the long-term health-related quality of life of children with congenital cardiac malformations following open-heart surgery, and to describe the persisting level of stress in their families. To this end, 49 parents completed the Child Health Questionnaire, the Parenting Stress Index, and the Child Behaviour Checklist as part of a developmental follow-up protocol when their child was 5 years of age. Mean scores on the Child Health Questionnaire were in the normal range, with physical well-being equal to 53.5, psychosocial well-being 50.9, with only 6.4 percent and 8.5 percent of subjects, respectively, falling within the suboptimal range of less than 40. The distribution of scores on the Parenting Stress Index, however, were more variable, with over one-quarter of parents indicating a high level of stress, with almost one-fifth having low levels of stress, and just over half scoring in the normal range, with the group mean being 52.6 plus or minus 32.3. An abnormal neurologic examination before surgery was associated with lower physical health (β equal to −5.5, p equal to 0.02, r2equal to 0.18), whereas lower arterial saturations of oxygen, less than 85 percent preoperatively, was associated with lower psychosocial health (β equal to −6.6, p equal to 0.01, and r2equal to 0.14). The internalizing and externalizing behaviours of the child were significantly correlated with psychosocial well being, with r ranging from −0.32 to −0.52, and p less than 0.05. Parental stress also correlated with psychosocial health (r equal to −0.48 and p equal to 0.0009). Overall, the perception by the parents of the health-related quality of life of their child is favourable 5 years following open-heart surgery during infancy. Many parents, nonetheless, continue to feel either stressed or defensive about their child, particularly if their child exhibits behavioural difficulties. Our findings suggest that strategies need to be considered to enhance family well-being in the planning and delivery of health services to this population at high risk.

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.

scholarly journals The Effects of Norepinephrine Infusion on the Circulating Lymphocyte Counts of Post–Open Heart Surgery Patients

2000 ◽  
Vol 1 (3) ◽  
pp. 199-209
Author(s):  
Wanda Zziwambazza ◽  
Carrie J. Merkle ◽  
Ida M. Moore ◽  
Jean Davis
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
The Other ◽  
Open Heart ◽  
Postoperative Infections ◽  
Norepinephrine Infusion ◽  
Beta Blocking ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In this retrospective study employing chart reviews, 75 open heart surgery patients (OHSPs) were divided into 3 groups of 25 patients. Group 1 received no intravenous (IV) norepinephrine (NE) after surgery. Group 2 and group 3 received a minimum of 0.028 mcg/kg/min of IV NE for 6-24 h and greater than 24 h, respectively. In the 3 groups, preoperative lymphocyte counts were compared to counts obtained on postoperative days 1 and 2. The results showed lower lymphocyte counts on postoperative day 2 in group 3 subjects, who received NE for 24 h or more, compared to subjects of the other groups who received no NE or 6-24 h of NE (p < 0.05). There was also evidence that preoperative use of beta-blocking agents significantly affected the change in lymphocyte counts from day 1 to day 2 in both groups receiving NE. Furthermore, postoperative infections were more prevalent in group 3 than the other 2 groups (p < 0.05). The lower lymphocyte counts and higher infection rate, however, may be linked to lower postoperative blood pressure and increased number of intensive care unit days in group 3. Further investigation is warranted to elucidate the effects of IV NE administration on the lymphocyte counts of OHSPs and to reduce infections in those receiving NE.

scholarly journals Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Azam Faraji ◽  
Alireza Khatony ◽  
Gholamreza Moradi ◽  
Alireza Abdi ◽  
Mansour Rezaei
Keyword(s):  
Clinical Trial ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Blood Gases ◽  
Open Heart ◽  
Blood Gas ◽  
Open Technique ◽  
Endotracheal Suctioning ◽  
Arterial Blood Gas ◽  
Arterial Blood

Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery.Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode.Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system(P<0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques(P<0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique(P<0.05).  Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.

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

Carbon dioxide field flooding techniques for open heart surgery: monitoring and minimizing potential adverse effects

Perfusion ◽  
2000 ◽  
Vol 15 (2) ◽  
pp. 151-153 ◽  
Author(s):  
Edward M Nadolny ◽  
Lars G Svensson
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Adverse Effects ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Blood Gas

The use of carbon dioxide for displacement of air in cardiac surgery can have potential adverse effects on blood gas strategies. Presented is a method of monitoring carbon dioxide in the cardiopulmonary bypass circuit and limiting the potential for severe hypercarbia during cardiopulmonary bypass.

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