Performance of polymethyl pentene oxygenators for neonatal extracorporeal membrane oxygenation: a comparison with silicone membrane oxygenators.
OBJECTIVE
To review the performance of polymethyl pentene versus silicone oxygenators in terms of efficiency in priming and oxygenation, oxygenator resistance, requirements for coagulation proteins and consumption of blood products, for neonatal extracorporeal membrane oxygenation (ECMO) patients.


METHODS
Forty consecutive neonates were selected retrospectively pre- and post-introduction of the new polymethyl pentene (PMP) oxygenators. They formed two equal groups. After calculation of the sample size, data were collected from ELSO registry forms and patient records. Results were analysed using parametric and non-parametric tests.


RESULTS
Neonatal PMP (N-PMP) oxygenators were smaller, faster and easier to prime. They were less efficient than silicone oxygenators, especially in carbon dioxide elimination, and, therefore, required higher sweeps. The preservation of coagulation proteins was significantly better, but there was no reduction in the consumption of blood products, despite having less than half the surface area and significantly lower blood path resistance.


CONCLUSIONS
Small PMP oxygenators (Medos Hilite 800 LT) provide adequate gas exchange and offer technical advantages in terms of more efficient priming, reduced haemodynamic resistance and better control and preservation of coagulation proteins than silicone oxygenators.
Khoshbin
Espeed
E
Division of Cardiac Surgery and Heart Link ECMO Centre, Glenfield University Hospital, Leicester, UK. khoshbinuk@yahoo.co.uk
Westrope
Claire
C
Pooboni
Suneel
S
Machin
David
D
Killer
Hilliary
H
Peek
Giles J
GJ
Sosnowski
Andrzej W
AW
Firmin
Richard K
RK
D004867:Equipment Design; D004868:Equipment Failure; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010107:Oxygenators, Membrane / Q000009:adverse effects / Q000706:statistics & numerical data*; D011090:Polyenes / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D012120:Respiration Disorders / Q000628:therapy*; D012189:Retrospective Studies; D012828:Silicones / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D016019:Survival Analysis; D013927:Thrombosis / Q000209:etiology
D011090:Polyenes; D012828:Silicones; C021245:poly(methylpentene)