A comparison of two oxygen transfer strategies: Bentley Univox and the Bard HF 5000

Fried, David W; Bell-Thomson, John

doi:10.1177/026765919200700210

Cited by 13 publications

(11 citation statements)

References 4 publications

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“…1,2 Coating the oxygenator with albumin in the prime should prevent the occurrence of this phenomenon. There are several published studies in the recent literature, some of these develop formulae that can be used as a tool to compare the different aspects of oxygenation and heat exchanger performance for a series of oxygenators, [3][4][5][6] or as a reference tool to test a single device for suboptimal functioning. [7][8][9][10] This study is designed to evaluate the performance characteristics of nine different types of hollow-fibre oxygenators in the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of nine hollow-fibre membrane oxygenators

et al. 2001

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In a comparative study we investigated the performance characteristics of nine hollow-fibre oxygenators. In a clinical setting, 10 units of each type of oxygenator were tested for oxygen exchange, transoxygenator pressure drop, heat exchanger performance and blood trauma. The oxygenators included are Maxima PRF Plus, Affinity, Forte, Affinity NT, Quantum, Optima, Capiox 1.8, Hilite and Quadrox. Ninety patients scheduled for elective coronary bypass surgery were enrolled in the study. Cardiotomy suction blood was not allowed to mix with the circulating blood. Samples were taken preoperatively (t1), immediately after cooling and crossclamping of the aorta (t2), during rewarming (t3), and postoperatively (t4). The results showed that under clinical conditions all of the tested oxygenators are well capable of meeting the normal and above-normal oxygen needs. The Quantum and Affinity NT are the best performing oxygenators with respect to oxygen transfer. The Quantum oxygenator with a small membrane surface area of 1.9 m2 has also the highest oxygen transfer per square metre. A direct relationship between shunt fraction and blood flow could not be established in all oxygenators. The lowest shunt fraction at 4 litres blood flow was seen in the Maxima, Quantum and Affinity NT groups (15%). At near physiological PaO2-values, we noticed a negative influence on the shunt fraction. Large differences exist in pressure drop between the oxygenators under standardized conditions with circulating priming, as well as during bypass. The lowest pressure drop was noticed in the Quadrox and Affinity NT, the highest in the Quantum, Capiox and Optima. However, we did not measure any differences in pressure drop after cooling and during re-warming. Differences exist between the heat exchanger performances. The Quadrox oxygenator is the most efficient, while the Maxima has the smallest performance factor. It was not possible to calculate heat exchanger performance for the Hilite due to incorrect temperature measurement. The high pressure gradients in some of the devices did not result in higher haemolysis. Plasma free haemoglobin values were low in each oxygenator. There are no differences in platelet drop postoperatively. The influence on blood trauma of the higher pressure drop in some of the tested devices, in combination with the higher centrifugal pump revolutions needed to overcome this gradient, has to be studied with longer perfusion times.

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Section: Introductionmentioning

confidence: 99%

Clinical evaluation of nine hollow-fibre membrane oxygenators

et al. 2001

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“…[2][3][4][5] The shunt fraction represents the percentage of venous blood which flows through the oxygenator without participating in effective gas exchange. Utilizing this technique, we were able to establish 'normal' or predicted shunt values for several different membrane oxygenators.…”

Section: Introductionmentioning

confidence: 99%

The proposed use of a 'screening test' to assess oxygenator performance

1993

Self Cite

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This study aimed to assess whether the use of the physiological shunt equation could (within the first five minutes of initiating CPB) serve as a 'screen' to differentiate normal and dysfunctional oxygenator performance. If dysfunction severe enough to require replacement was necessary, the normothermic patient could be weaned from CPB and replacement would be carried out under safe, controlled conditions. This technique would require postponing the induction of hypothermia (if used), aortic cross-clamping, and arresting the heart until after this screen was completed. This study demonstrates that a strong negative correlation exists between the degree of blood shunting and the membrane's 0 2 transfer performance (r = -0.874). This relation enables us to predict 0 2 transfer performance when only the shunt fraction is known. Of the 41 oxygenators used in this study, 40 demonstrated normal, or below-normal, shunt fractions. Oxygen transfer performance at or above predicted levels would be anticipated for these oxygenators. One of the 41 oxygenators had mildly elevated shunt fractions, which we predicted would be associated with mild 0 2 transfer dysfunction. Based on the performance screen worksheet we created, replacement was not necessary since the oxygenator maintained high levels of 0 2 transfer in reserve despite its marginal performance dysfunction. Assessment of oxygenator performance dysfunction in this earliest phase of CPB would greatly reduce the incidence of emergency oxygenator replacement secondary to actual or perceived oxygenator failure later in the course of the procedure.

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“…Again, there is a group of oxygenators with a lower resistance, the HF 5400 (2.4-1.87 mmHg/min/ml 02), the AFFI-NITY (2.63-1.87 mmHg/min/ml 02), followed by a group with a higher resistance, the OXIM 11-34 (2.72-2.45 (8.7-10.9%), the CM 50 (2.4-11.9%), the UNIVOX (8.9-13.3%), the OXIM 11-34 (17. [3][4][5][6][7][8][9][10][11][12][13][14][15].5%) and the SAFE 11 (9.8-16.1%). …”

Section: Resultsmentioning

confidence: 99%

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

Stinkens¹,

Himpe²,

Thyssen³

et al. 1996

Perfusion

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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.

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A comparison of two oxygen transfer strategies: Bentley Univox and the Bard HF 5000

Cited by 13 publications

References 4 publications

Clinical evaluation of nine hollow-fibre membrane oxygenators

Clinical evaluation of nine hollow-fibre membrane oxygenators

The proposed use of a 'screening test' to assess oxygenator performance

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

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