Air handling characteristics of five membrane oxygenators

Abstract

This project looked at the potential of five different membrane oxygenators to allow passage of catastrophic quantities of air in a clinically simulated environment. All the oxygenators were set up in an identical circuit using heparinized human blood as the perfusate. The study was carried out at flow rates ranging from 1.0 to 6.0 I/min. The clinical situation of obstructed venous drainage was simulated by clamping the venous return line at each respective flow rate, while the initial level of blood in the open system hard shell venous reservoir was maintained at 600 ml. The time interval between the application of the clamp on the venous line and the first appearance of macroscopic air in the arterial line was recorded at each level of flow rate. A graph of time versus flow rate was plotted for each oxygenator type. At a flow rate of 6 I/min, the Safe II oxygenator took 20 seconds to allow passage of air after the venous line was clamped, while it took the Bentley Univox Oxygenator only 10 seconds. The Dideco oxygenator, which has a valve incorporated in its reservoir, did not, however, allow any air to be pumped forward at all. At low flow rates, some of the oxygenators offered protection against passage of air into the arterial line. Thus the Cobe oxygenator offered protection at flow rates of less than 2 I/min, the Safe II oxygenator at flow rates of up to 2.5 I/min and the Bard oxygenator at flow rates up to 3 I/min. This study has demonstrated the potential of membrane oxygenators to allow passage to clinical quantities of air into the arterial line. This study also has demonstrated that the top to bottom flow feature offers protection against passage of air at low flow rates only, while a simple valve is quite effective in preventing passage of air at a wide range of clinically relevant flow rates.