Evaluation of the thrombogenicity of selected microporous oxygenator membranes

Oxygenator anatomy and function

The natural lung is the organ responsible for oxygen and carbon dioxide exchange between the blood and the outside environment. This function is accomplished by the large surface area and high permeability of the gas exchange interface, the alveolar-capillary membrane. These same features are fundamental to the design of an artificial lung, or oxygenator. Additional lung-like features essential to the design of an ideal oxygenator include the ability to achieve balanced oxygen and carbon dioxide exchange with minimal blood damage and blood activation. The purpose of this review is to present the past and current developments of the oxygenator designs in terms of the structural and functional features of the natural lung as well as the limitations in the ability to mimic the features of the lung because of the lack of appropriate technology.

Evaluation of high-frequency jet ventilation in oxygenation through an artificial membrane lung

The membrane oxygenator often develops impaired gas exchange after prolonged use because plasma proteins adhere to the membrane's surface and leak through its micropores. This study was performed to examine the efficacy of high-frequency jet ventilation (HFJV) in minimizing these problems in a "flat plate" type of membrane oxygenator. We first vibrated the membrane of the oxygenator by HFJV from 1 to 10 Hz to find the frequency most effective for optimal gas exchange in animals with partial extracorporeal circulation. These studies suggested that 6 Hz HFJV was preferable in our model. We subsequently performed in vivo extracorporeal oxygenation in dogs for 8 h using the membrane oxygenator with or without 6 Hz HFJV. Although the gas exchange capacity within the first 8 h was similar in the two groups, after 6 h a significant decrease in the red blood cell count and in the hematocrit was found in the group not receiving HFJV. Scanning electron microscopic examination of the membranes after 8 h of use disclosed that the membrane from the group receiving HFJV had less plasma protein and fibrin adhesion than that from the group not receiving HFJV. Moreover, it appears that with prolonged extracorporeal oxygenation, 6 Hz HFJV also protects against a decrease in the hematocrit of the passed blood and might lead to enhanced gas exchange. Our data suggest that good gas exchange can be maintained for periods even longer than 8 h if HFJV is used in conjunction with the membrane oxygenator.

Emergency bypass system: analysis of gas transfer

A portable emergency bypass system using a membrane oxygenator device (CPS) was evaluated. The ability of the CPS to supply the oxygen transfer needs of five anesthetized dogs consistently over six hours and the system's effects on hemoglobin concentration, platelet count, and degree of hemolysis were assessed. The animals maintained spontaneous heart beats, pump flows averaged 100 ml/kg/min; mean arterial pressures were maintained at from 114 to 144 mm Hg. Immediate dilution of hemoglobin and platelet levels occurred in the first 30 minutes. Further hemodilution was limited during the first two hours, although three of the animals required transfusions during the six-hour period to maintain their hematocrits. Plasma free hemoglobin did not significantly increase during the six hours. Baseline oxygen consumption data obtained in three animals ranged from 44.5 to 96 (ml oxygen/min/m2). Oxygen and carbon dioxide transfer measurements during the first hour of bypass were not significantly different from measurements during the last hour of perfusion. The study suggests that optimal use of the CPS could supply much if not all of a patient's basal oxygen transfer requirements for at least six hours.