Potential problem when using the new lower-prime hollow-fibre membrane oxygenators with uncoated stainless steel heat exchangers
Potential problem when using the new lower-prime hollow-fibre membrane oxygenators with uncoated stainless steel heat exchangers
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使用带有无涂层不锈钢热交换器的新型低注中空纤维膜充氧器时的潜在问题
DOI：
10.1177/026765919601100610
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Patrick C Meloy
中科院分区：
文献类型：
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作者：
D. Palanzo;N. J. Manley;R. M. Montesano;Michael Quinn;Barbara;Patricia A Gustafson;Debra L Zarro;Patrick C Meloy
进行了一项前瞻性研究，以评价常规心肺转流（CPB）期间三种不同中空纤维膜式氧合器的跨氧合器压力梯度。将60例连续心脏直视手术患者随机分为3组，每组接受不同型号的膜式氧合器。CPB期间每15 min记录一次患者的压力、血流量、呼吸机转数和鼓膜温度。在研究组中，有一部分患者表现出高的跨氧合器压力。虽然这些事件大多数是短暂的，并在一段时间内得到解决，但在几个病例中，高跨膜压持续存在，导致氧合器性能下降。在一个这样的情况下，需要更换氧合器。经过广泛的分析和审查，唯一的相似性或相关性是较新的低预充中空纤维膜式氧合器（具有相应的狭窄血液通道）和一体式无涂层不锈钢热交换器的结合。需要进行进一步的研究，以查明参与这种现象的机制和病理生理学。
A prospective study was conducted to evaluate the trans-oxygenator pressure gradient across three different hollow-fibre membrane oxygenators during routine cardiopulmonary bypass (CPB). Sixty consecutive open-heart surgery patients were randomly divided into three groups each receiving a different model of membrane oxygenator. Inlet and outlet pressures, as well as patients' pressures, blood flow, revolutions per minute and tympanic membrane temperature were recorded every 15 min during CPB. Within the study groups, there were subsets of patients who exhibited high trans- oxygenator pressures. Although most of these episodes were transient and resolved over a period of time, there were several cases during which the high trans-membrane pressures persisted, resulting in decreasing oxygenator performance. In one such case, oxygenator change-out was required. After extensive analysis and review, the only similarities or correlation that could be made were with the marriage of the newer lower- prime hollow-fibre membrane oxygenators (with corresponding narrow blood path) and the integral uncoated stainless steel heat exchangers. Further study needs to be performed to pinpoint the mechanism and pathophysiology that are involved in this phenomenon.