Testing of heat exchangers in membrane oxygenators using air pressure

Abstract

All heat exchangers (HE) in membrane oxygenators are tested by the manufacturer for water leaks during the production phase. However, for safety reasons, it is highly recommended that HEs be tested again before clinical use. The most common method is to attach the heater-cooler to the HE and allow the water to recirculate for at least 10 min, during which time a water leak should be evident. To improve the detection of water leaks, a test was devised using a pressure manometer with an integrated bulb used to pressurize the HE with air. The cardiopulmonary bypass system is set up as per protocol. A pressure manometer adapted to a 1/2″ tubing is connected to the water inlet side of the oxygenator. The water outlet side is blocked with a short piece of 1/2″ dead-end tubing. The HE is pressurized with 250 mmHg for at least 30 sec and observed for any drop. Over the last 2 years, only one oxygenator has been detected with a water leak in which the air-method leak-test was performed. This unit was sent back to the manufacturer who confirmed the failure. Even though the incidence of water leaks is very low, it does occur and it is, therefore, important that all HEs are tested before they are used clinically. This method of using a pressure manometer offers many advantages, as the HE can be tested outside of the operating room (OR), allowing earlier testing of the oxygenator, no water contact is necessary, and it is simple, easy and quick to perform.