Translational Research: Comparing Oxygenators From Different International Markets

Matte, Gregory S.; Neirotti, Rodolfo A.

doi:10.1111/aor.12996

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…All of the CPB circuit components - oxygenator with or without an integrated ALF, venous and cardiotomy reservoirs, A-V cannulae, and tubing - should be evaluated in vitro to determine their hydrodynamic performance before they are used in clinical practice [ 16 - 18 ] . Brazil has a large number of medical devices manufactured and available only in this region which are approved by the National Health Surveillance Agency.…”

Section: Discussionmentioning

confidence: 99%

Functional Performance of Different Venous Limb Options in Simulated Neonatal/Pediatric Cardiopulmonary Bypass Circuits

Canêo¹,

Matte²,

Guimaraes³

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveHemodilution is a concern in cardiopulmonary bypass (CPB). Using a smaller dual tubing rather than a single larger inner diameter (ID) tubing in the venous limb to decrease prime volume has been a standard practice. The purpose of this study is to evaluate these tubing options.MethodsFour different CPB circuits primed with blood (hematocrit 30%) were investigated. Two setups were used with two circuits for each one. In Setup I, a neonatal oxygenator was connected to dual 3/16" ID venous limbs (Circuit A) or to a single 1/4" ID venous limb (Circuit B); and in Setup II, a pediatric oxygenator was connected to dual 1/4" ID venous limbs (Circuit C) or a single 3/8" ID venous limb (Circuit D). Trials were conducted at arterial flow rates of 500 ml/min up to 1500 ml/min (Setup I) and up to 3000 ml/min (Setup II), at 36°C and 28°C.ResultsCircuit B exhibited a higher venous flow rate than Circuit A, and Circuit D exhibited a higher venous flow rate than Circuit C, at both temperatures. Flow resistance was significantly higher in Circuits A and C than in Circuits B (P<0.001) and D (P<0.001), respectively.ConclusionA single 1/4" venous limb is better than dual 3/16" venous limbs at all flow rates, up to 1500 ml/min. Moreover, a single 3/8" venous limb is better than dual 1/4" venous limbs, up to 3000 ml/min. Our findings strongly suggest a revision of perfusion practice to include single venous limb circuits for CPB.

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Section: Discussionmentioning

confidence: 99%

Functional Performance of Different Venous Limb Options in Simulated Neonatal/Pediatric Cardiopulmonary Bypass Circuits

Canêo¹,

Matte²,

Guimaraes³

et al. 2018

Braz J Cardiovasc Surg

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“…The IQIC perfusion education project has already yielded multicenter collaborative publications with member institutions and centers within the United States. The first was a letter‐to‐the‐editor published in Artificial Organs in response to a multicenter evaluation of oxygenator devices the journal published . This was followed with a study evaluating bypass circuit venous limb options .…”

Section: Perfusion Practice Webinarsmentioning

confidence: 99%

Global outreach to improve the provision of cardiopulmonary bypass for patients with congenital heart disease

Matte

2018

Artificial Organs

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“…To the Editor, In response to our recent publication on membrane oxygenators (1), we have read the letter entitled "Translational research: comparing oxygenators from different international markets" by Matte and Neirotti with a great interest (2). We very much appreciate their constructive comments and suggestions.…”

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confidence: 99%

Translational Research on Evaluation of Pediatric Cardiopulmonary Bypass Oxygenators

Ündar

2018

Artificial Organs

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In response to our recent publication on membrane oxygenators (1), we have read the letter entitled "Translational research: comparing oxygenators from different international markets" by Matte and Neirotti with a great interest (2). We very much appreciate their constructive comments and suggestions. We would like to include a brief clarification of the conclusions for that particular international multicenter and multidisciplinary study (1).Our recent study was a continuation of our previous collaboration regarding the evaluation of neonatal oxygenators used at the Heart Institute of the University of Sao Paulo, Brazil. In the first study, we compared the Braile infant 1500 oxygenator and the Dideco Kids D100 oxygenator in a neonatal set-up (3). We used an arterial filter along with Penn State Children's Hospital's neonatal tubing packs (Sorin) for both circuits. In the earlier study, the Braile neonatal oxygenator had a better hemodynamic performance and gaseous microemboli capturing ability when compared to the Dideco Kids D100 oxygenator (3).In the current study, pediatric oxygenators (Braile infant oxygenator and Maquet Quadrox-I oxygenator without an integrated arterial filter) along with custom-made tubing packs from the Heart Institute of the University of Sao Paulo were used because we focused on the cardiopulmonary bypass (CPB) circuitry used by that particular organization. Based on the results of this particular study, the Quadrox-i oxygenator trapped more emboli compared to the Braile. We would like to clarify that these current results and suggestions are intended for clinical practices in Latin American countries that use the same CPB circuitry.Based on our translational research projects that tested other neonatal, pediatric, and adult CPB oxygenators, we recommend different hollow-fiber membrane oxygenators for clinical practice in the USA (4-7). As always, our recommendations are based on our multidisciplinary research team's collective efforts and scientific evidence, along with the FDA approval of current devices in the US market (8).We also believe that, in addition to our current approach for evaluating different oxygenators in terms of hemodynamic performance and microemboli capturing, the testing standards for membrane oxygenators and the instruction for their clinical use should be updated (9).

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Translational Research: Comparing Oxygenators From Different International Markets

Cited by 3 publications

References 14 publications

Functional Performance of Different Venous Limb Options in Simulated Neonatal/Pediatric Cardiopulmonary Bypass Circuits

Functional Performance of Different Venous Limb Options in Simulated Neonatal/Pediatric Cardiopulmonary Bypass Circuits

Global outreach to improve the provision of cardiopulmonary bypass for patients with congenital heart disease

Translational Research on Evaluation of Pediatric Cardiopulmonary Bypass Oxygenators

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