Experience with the Jostra Rotaflow and QuadroxD oxygenator for ECMO
Experience with the Jostra Rotaflow and QuadroxD oxygenator for ECMO
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DOI：
10.1191/0267659104pf702oa
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发表时间：
2004-01-01
期刊：
影响因子：
1.2
通讯作者：
Brizard, C
中科院分区：
文献类型：
--
作者：
Horton, S;Thuys, C;Brizard, C
自1988年4月以来，我们已经能够为通气失败或心脏手术后需要心肺支持的患者提供体外膜氧合（ECMO）。在此期间，我们支持了211名患者，其中大多数患者使用Avecor（Affinity，Avecor Cardiovascular Inc.，美国明尼苏达州明尼阿波利斯）螺旋缠绕硅胶膜氧合器。我们中心已使用微孔中空纤维氧合器（18%）。然而，由于它们的早期失败，它们必须转换为可能持续整个ECMO过程的设备，即，Avecor随后在Quadrox（D）（Jostra Medizintechnik AG，Hölingen，德国）推出之前未被常规使用。聚-4-甲基-1-戊烯扩散膜的最新发展使我们能够利用中空纤维技术与真正的（非微孔）膜。这使我们能够使用这种低电阻器件的所有固有的优点，没有等离子体泄漏需要电路转换。从2000年7月起，我们开始为需要ECMO支持的患者使用QuadroxD氧合器。体重范围为2.16-51.0 kg的患者（n = 23），最长支持时间为1119小时。这项新技术使我们能够为所有体型的患者使用单一设备，因此我们现在可以随时设置ECMO回路，最大限度地减少提供支持所需的时间，从而可能改善幸存者的发病率。
Since April 1988, we have been able to offer extracorporeal membrane oxygenation (ECMO) to patients who are either failing ventilation or who need cardiopulmonary support following cardiac surgery. During this time, we have supported 211 patients, the majority of whom have been supported with the Avecor (Affinity, Avecor Cardiovascular Inc., Minneapolis, MN, USA) spiral wound silicone-membrane oxygenator. Microporous hollow-fibre oxygenators have been used (18%) at our center. However, due to their early failure, they have necessitated conversion to a device that potentially would last for the entire ECMO course, i.e., Avecor and, subsequently, have not been used routinely until the introduction of the Quadrox(D) (Jostra Medizintechnik AG, Hirrlingen, Germany). The recent development of the poly-4-methyl-1-pentene diffusion membrane allows us to utilize hollow-fibre technology with a true (nonmicroporous) membrane. This has enabled us to use this low-resistance device with all its inherent advantages, without plasma leakage necessitating circuit changeover. From July 2000, we have used the QuadroxD oxygenator for our patients requiring ECMO support. This has been in patients with weights ranging from 2.16-51.0 kg (n = 23), with the longest support being for 1119 hours. This new technology has enabled us to utilize a single device for all patient sizes, so we now have an ECMO circuit set up at all times, minimizing the time required for support to be available, potentially improving survivor morbidity.