Blood compatibility of two different types of membrane oxygenator during cardiopulmonary bypass in infants

Gu, Yongquan; Boonstra, PW; Akkerman, C.; Mungroop, Hubert E.; Tigchelaar, [No Value]; Vanoeveren, W

doi:10.1177/039139889401701006

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…This was indicated by a similar increase of C3a in the hollow fiber and flat sheet groups during CPB whereas a difference was seen in the increase of elastase between the 2 groups. This is in contrast to results from a previous study in infants that indicated C3a was significantly higher in the flat sheet oxygenator group than in the hollow fiber oxygenator group (16). The difference between infants and adults may suggest that in infants complement activation as well as the subsequent leukocyte activation are more dependent on surface contact.…”

Section: Discussioncontrasting

confidence: 99%

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Gu¹,

Boonstra²,

Graaff

et al. 2000

Artificial Organs

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The membrane oxygenator is known to be superior to the bubble oxygenator, but little information is available about the difference between the hollow fiber and flat sheet membrane oxygenators with regard to pressure drop, shear stress, and leukocyte activation. In this study, we compared these 2 types of membrane oxygenators in patients undergoing cardiopulmonary bypass (CPB) surgery with special focus on leukocyte activation and pressure drop across the oxygenators. Plasma concentration of elastase, a marker indicating leukocyte activation, increased to 593+/-68% in the flat sheet oxygenator group versus 197+/-42% in the hollow fiber oxygenator group (p<0.01) at the end of CPB compared to their respective baseline concentrations before CPB. Pressure drop across the oxygenator was significantly higher in the flat sheet group than in the hollow fiber group throughout the entire period of CPB (p<0.01). High pressure drop across the oxygenator as well as the calculated shear stress was positively correlated with the release of elastase at the end of CPB (r = 0.760, p<0.01, r = 0.692, p<0.01). However, this positive correlation existed in the flat sheet oxygenator but not in the hollow fiber oxygenator. Clinically, both membrane oxygenators have satisfactory performance in O2 and CO2 transfer. These results suggest that a higher pressure drop across the flat sheet oxygenator is associated with more pronounced activation of leukocytes in patients undergoing cardiopulmonary bypass.

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Section: Discussioncontrasting

confidence: 99%

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Gu¹,

Boonstra²,

Graaff

et al. 2000

Artificial Organs

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“…As a result, there was a very large blood-membrane contact surface area in this system. Therefore, we expected to observe a considerable inflammatory response after CPB with this setup (Gu et al, 1994). We did not detect a TNF-α acute phase response and we found a late rise in IL-6 levels, with a comparable pattern in both the sham and the CPB group.…”

Section: Discussionmentioning

confidence: 61%

Cardiopulmonary bypass and long-term neurocognitive dysfunction in the rat

et al. 2006

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“…15,16 The hollow-fibre polypropylene membrane oxygenator with the smallest surface area resulted in significantly less C3a generation than the other types. 8 Although the oxygenators differ in configuration, the surface is the primary trigger for complement activation, and therefore the results are likely to be explained by the smaller contact surface area of the hollow-fibre membrane. 5,8 The difference that was observed between the silicone membrane (group 3) and the polypropylene membrane with approximately the same surface area (group 2), most likely represents the larger trigger of complement activation by the silicone than that of the polypropylene surface.…”

Section: Discussionmentioning

confidence: 99%

“…8 Although the oxygenators differ in configuration, the surface is the primary trigger for complement activation, and therefore the results are likely to be explained by the smaller contact surface area of the hollow-fibre membrane. 5,8 The difference that was observed between the silicone membrane (group 3) and the polypropylene membrane with approximately the same surface area (group 2), most likely represents the larger trigger of complement activation by the silicone than that of the polypropylene surface. 3,9 It is well known that after the administration of protamine sulphate, the complement system is activated by the classical pathway.…”

Section: Discussionmentioning

confidence: 99%

Biocompatibility of three different membrane oxygenators: effects on complement, neutrophil and monocyte activation

et al. 1997

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The inflammatory reaction of extracorporeal circuits can be assessed by measuring complement activation and the release of activation markers of leucocytes. The purpose of this study was to compare three commercially available membrane oxygenators with respect to complement (C3a), granulocyte (lactoferrin) and monocyte (interleukin-6, IL-6) activation. Thirty patients undergoing cardiac surgery were randomly assigned to undergo cardiopulmonary bypass (CPB) with one of the following oxygenators: a polypropylene hollow-fibre membrane (group 1; 2.2 m2), a polypropylene flat-sheet membrane (group 2; 3.1 m2) or a silicone envelope membrane (group 3, 3.5 m2). In all patients, a significant increase in C3a in plasma occurred during CPB with peak levels after the administration of protamine sulphate. In blood samples taken before aortic crossclamp release, at the end of CPB, and 20 min after protamine administration C3a was significantly lower in group 1 than in the other two groups. Lactoferrin increased significantly during CPB in all patients without a significant difference between the groups. IL-6 did not increase during CPB, but raised significantly after 4 h in the intensive care unit in all groups. Moreover, IL-6 was significant lower in group 1 than group 3. The data suggest that the polypropylene hollow-fibre membrane oxygenator, i.e. the oxygenator with the smallest surface area, is more biocompatible than the other types, probably because of a smaller contact surface area.

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Blood compatibility of two different types of membrane oxygenator during cardiopulmonary bypass in infants

Cited by 10 publications

References 15 publications

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Pressure Drop, Shear Stress, and Activation of Leukocytes During Cardiopulmonary Bypass: A Comparison Between Hollow Fiber and Flat Sheet Membrane Oxygenators

Cardiopulmonary bypass and long-term neurocognitive dysfunction in the rat

Biocompatibility of three different membrane oxygenators: effects on complement, neutrophil and monocyte activation

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