A polymethylpentene fiber gas exchanger for long-term extracorporeal life support.
A polymethylpentene (PMP) fiber gas exchange device was evaluated in healthy sheep (35-42 kg) to characterize its performance and potential use in clinical extracorporeal life support (ECLS). Five PMP devices (1.3 m2) were compared with five silicone rubber membrane lung (SRML) devices (1.5 m2) that were supported on venovenous ECLS for 72 hours. The two device groups were compared for differences in gas exchange, device pressure gradient, hematology, blood biochemistry, and pathology. The results showed superiority in the PMP devices in both oxygen and CO2 exchange when compared at similar blood flow rates. Platelet consumption and the device pressure gradient were significantly less when using the PMP device. The device pressure gradient across the PMP devices was < 20 mm Hg as compared with > 150 mm Hg for the SRML devices at all blood flow rates. Changes in plasma hemoglobin levels, leukocyte counts, blood chemistry results, and pathologic findings were not significantly different between the two device groups. Plasma leakage or device failure did not occur in any of the test devices. These data support the use of the PMP device for extended circulatory support. Patients may fare better because of improved preservation of platelets, and the low resistance may allow for wider use of centrifugal-style pumps or the use of the device in a pumpless arteriovenous mode.
Toomasian
John M
JM
University of Michigan, Extracorporeal Circulation Laboratory, Department of Surgery, Ann Arbor, MI, USA.
Schreiner
Robert J
RJ
Meyer
David E
DE
Schmidt
Monica E
ME
Hagan
Sarah E
SE
Griffith
Grant W
GW
Bartlett
Robert H
RH
Cook
Keith E
KE
D000475:Alkenes / Q000737:chemistry*; D000818:Animals; D001774:Blood Chemical Analysis; D002245:Carbon Dioxide / Q000097:blood; D002408:Catheters, Indwelling; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D007601:Jugular Veins; D007958:Leukocyte Count; D008021:Life Support Systems / Q000295:instrumentation; D010100:Oxygen / Q000097:blood; D010107:Oxygenators, Membrane; D011659:Pulmonary Gas Exchange; D012756:Sheep; D013997:Time Factors; D014682:Vena Cava, Inferior
D000475:Alkenes; D006454:Hemoglobins; D002245:Carbon Dioxide; D010100:Oxygen