title: Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation.
abstract: The performance of poly-methyl pentene (PMP) oxygenators (Medos Hilite 7000LT) was compared with that of silicone membrane (SM) oxygenators (Medtronic 1-4500-2A) for adult extracorporeal membrane oxygenation (ECMO). Forty consecutive patients were selected retrospectively pre- and post-introduction of PMP oxygenators. They were selected according to the dates they received ECMO and were separated into two equal groups with similar backgrounds. The flow path resistance, gas and heat exchange efficiency, consumption of coagulation factors and platelets, blood transfusion requirements, and incidence of clots for each oxygenator type was assessed. Adult PMP oxygenators showed lower blood path resistance than SM oxygenators. However, lower consumption of blood products in these oxygenators was a direct result of their smaller surface area and heparin coated design, reducing contact activation of coagulation factors. These oxygenators are noticeably smaller, require lower priming volumes, and have better gas exchange capability than SM oxygenators. They showed greater stability and preservation of coagulation factors and platelets compared with SM oxygenators. They also had the advantage of a functioning integrated heat exchanger. Using a single PMP oxygenator in the first instance may be adequate for the majority of patients and would significantly reduce red blood cell consumption during ECMO.
authors.affiliation: Division of Cardiac Surgery, University of Leicester, and the Heart link ECMO Center, Glenfield Hospital, University Hospitals of Leicester NHS trust, Groby road, Leicester, United Kingdom.
authors.forename: Espeed
authors.initials: E
authors.lastname: Khoshbin
authors.forename: Neil
authors.initials: N
authors.lastname: Roberts
authors.forename: Chris
authors.initials: C
authors.lastname: Harvey
authors.forename: David
authors.initials: D
authors.lastname: Machin
authors.forename: Hilliary
authors.initials: H
authors.lastname: Killer
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Peek
authors.forename: Andrzej W
authors.initials: AW
authors.lastname: Sosnowski
authors.forename: Richard K
authors.initials: RK
authors.lastname: Firmin
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D001803:Blood Transfusion; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011659:Pulmonary Gas Exchange; D012017:Referral and Consultation; D012189:Retrospective Studies