Impact of prolonged saline solution prime exposure on integrity of extracorporeal membrane oxygenation circuits.
OBJECTIVE
Our purpose was to evaluate the safety of the common practice of preparing extracorporeal membrane oxygenation (ECMO) circuits in advance with saline solution priming by analysis of the surfaces of circuit components and analysis of the prime solution for toxic contaminations.


METHODS
In vitro analysis of eight ECMO circuits exposed to saline prime solution for 0, 2, or 4 weeks was performed with scanning electron microscopy. Prime solution analyzed for contamination with aluminum, silicone, and diethylhexylphthalate.


RESULTS
The silicone membrane and heat exchanger demonstrated surface degradation in contact with saline solution. The prime solution showed increasing concentrations of both aluminum and silicone but not diethylhexylphthalate over time.


CONCLUSIONS
Advance preparation of ECMO circuits by prepriming with normal saline solution leads to significant circuit degradation. Prepriming should be avoided.
Riley
B J
BJ
Department of Pediatrics, Rainbow Babies and Childrens Hospital, Cleveland, OH 44106-6010, USA.
Sapatnekar
S
S
Cornell
D J
DJ
Anderson
J
J
Walsh-Sukys
M C
MC
D000535:Aluminum / Q000032:analysis; D004051:Diethylhexyl Phthalate / Q000032:analysis; D015199:Extracorporeal Membrane Oxygenation; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007231:Infant, Newborn; D008567:Membranes, Artificial; D008855:Microscopy, Electron, Scanning; D012826:Silicone Elastomers / Q000737:chemistry*; D012828:Silicones / Q000032:analysis; D012965:Sodium Chloride / Q000737:chemistry / Q000494:pharmacology*; D013499:Surface Properties / Q000187:drug effects
D008567:Membranes, Artificial; D012826:Silicone Elastomers; D012828:Silicones; D012965:Sodium Chloride; D004051:Diethylhexyl Phthalate; D000535:Aluminum