Heparin-coated equipment reduces the risk of oxygenator failure.
BACKGROUND
The development of an abnormal pressure gradient (APG) across the oxygenator is the most common cause of oxygenator failure during cardiopulmonary bypass. This necessitated changing the oxygenator in 4 patients in this series. A retrospective analysis of conditions predisposing to APG was performed.


METHODS
One thousand nine hundred fifty-nine operations with cardiopulmonary bypass were performed in adults. A range of membrane oxygenators was used subject to availability; 769 oxygenators were heparin-coated and 1,190 were uncoated. The pressure gradient across the oxygenator was measured under standardized conditions. An APG was defined as a gradient of greater than twice the mean.


RESULTS
An APG occurred in 44 uncoated and 3 heparin-coated oxygenators (p < 0.001). The mean age was higher for the APG group (p < 0.001). Fibrin deposits in the arterial line filter were noted in 45 patients. Logistic regression revealed that only fibrin deposition in the arterial line filter and the use of uncoated oxygenators were significantly associated with APG.


CONCLUSIONS
We conclude that a heparin-coated oxygenator effectively prevents APG. This adds significantly to the safety of open heart operations.
Wahba
A
A
Department of Cardiothoracic Surgery, University of Regensburg, Germany. wahba@klinik.uni.regensburg.de
Philipp
A
A
Behr
R
R
Birnbaum
D E
DE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005337:Fibrin / Q000737:chemistry; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D011312:Pressure; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D013499:Surface Properties; D015996:Survival Rate
D000925:Anticoagulants; D005337:Fibrin; D006493:Heparin