Clinical evaluation of the oxygenation capacity and controllability of 15 commercially available membrane oxygenators during alpha-stat regulated hypothermic cardiopulmonary bypass

Abstract

Oxygenation performance was tested in 15 membrane oxygenators by calculating the resistance for oxygenation (R) and the calculation of oxygen transferred versus FiO2. The clinical data reveal that the SARNS Turbo 440 (36.7-51.9%), the AFFINITY (37.2-50.1 %) and the HF 5400 (37.5-52.3%) are the oxygenators with the lowest FiO2 settings for comparable amounts of oxygen transferred during hypothermia and during normothermia followed by MAXIMA Plus (39.1-55.8%), MAXIMA Plus PRF (39.1-56.2%), CAPIOX SX 18 (39.7-61.2%), MONOLYTH (43.0-61.3%), OXIM 11-34 (44.1-63.9%), COBE Duo (44.7-64.9%), COBE Optima (47.4-66.4%), COMPACTFLO (48.3-65.3%), SAFE II (49.0-67.6%), UNIVOX (49.8-71.3%), MAXIMA (50.2-70.1 %) and the CM 50 (58.6-77.0%). Similar results were found by calculation of R. HF 5400 (2.41-1.87 mmHg/min/ml O2), AFFINITY (2.63-1.87 mmHg/min/ml O2), OXIM II-34 (2.72-2.45 mmHg/min/ml O2), MAXIMA Plus PRF (2.75-2.07 mmHg/min/ ml O2), COBE Optima (2.83-2.13 mmHg/min/ml O2), UNIVOX (2.84-2.17 mmHg/min/ml O2), MONOLYTH (2.89-2.24 mmHg/min/ml O2), SARNS Turbo 440 (3.03-2.12 mmHg/min/ml O2), MAXIMA Plus (3.09-2.28 mmHg/min/ml O2), SAFE 11 (3.19-2.50 mmHg/min/ml O2), CAPIOX SX 18 (3.27-2.44 mmHg/ min/ml O2), COMPACTFLO (3.41-2.50 mmHg/min/ml O2), MAXIMA (3.53-2.72 mmHg/min/ml O2), COBE Duo (3.57-2.71 mmHg/min/ml O2) and the CM 50 (3.53-2.72 mmHg/min/ml O2). As a measure of controllability of oxygenation, the coefficient of variation on the FiO2 ordered on the normothermic blood samples was used, giving as a result CAPIOX SX 18 (2.9-2.5%), AFFINITY (3.6-3.5%), COBE Duo (4.3-2.9%), HF 5400 (5.7-4.7%), MAXIMA Plus (8.1- 5.4%), COMPACTFLO (8.2-5.0%), MONOLYTH (8.3-4.0%), MAXIMA (8.7- 3.4%), COBE Optima (9.6-6.8%), SARNS Turbo 440 (10.1-7.3%), MAXIMA Plus PRF (10.9-8.7%), CM 50 (11.9-2.4%), UNIVOX (13.3-8.9%), OXIM 11-34 (15.5-17.3%) and the SAFE II (16.1-9.8%). The low FiO2 settings and the lower resistance for oxygenation are an indication of the reserve capacity of the oxygenators whose importance is proven by clinical data of emergency perfusions on patients under full resuscitation.