title: Extracorporeal membrane oxygenation with a poly-methylpentene oxygenator (Quadrox D). The experience of a single Italian centre in adult patients with refractory cardiogenic shock.
abstract: Although microporous polypropylene hollow fiber oxygenators are standard devices used for extracorporeal membrane oxygenation (ECMO), they have limitations such as development of plasma leakage. Poly-methylpentene (PMP) is a new material used for the last generation of oxygenators. We reviewed our experience with a new PMP oxygenator (Quadrox D) and a centrifugal pump (RotaFlow) used to support adult patients with refractory cardiogenic shock. Between January 2000 and April 2007, 25 patients required ECMO for primary or postcardiotomy cardiogenic shock. Eighteen patients were analyzed [mean age 60.2 years; 11 (61%) men; 7 (39%) women]. Nine patients (50%) suffered primary cardiogenic shock. Cardiopulmonary resuscitation was applied in 11 patients (61%) with a mean duration time of 31.5 minutes. Mean ECMO duration time was 7.1 +/- 6.3 days (range, 1-27 days). Intra-aortic balloon pump was used in 13 patients (72.2%) with a mean duration time of 7.7 +/- 5 (range, 2-17 days). Twelve patients (66.7%) survived on ECMO and five patients (27.8%) were discharged. Our results indicate the PMP oxygenator and the centrifugal pump provided acceptable results in terms of surviving on ECMO and discharge. Patients with an initial catastrophic hemodynamic status could benefit by means of a rapid institution of ECMO with PMP oxygenators.
authors.affiliation: Cardiac Surgery Clinic, University of Milano-Bicocca, Monza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Formica
authors.forename: Leonello
authors.initials: L
authors.lastname: Avalli
authors.forename: Antonello
authors.initials: A
authors.lastname: Martino
authors.forename: Elena
authors.initials: E
authors.lastname: Maggioni
authors.forename: Maria
authors.initials: M
authors.lastname: Muratore
authors.forename: Orazio
authors.initials: O
authors.lastname: Ferro
authors.forename: Antonio
authors.initials: A
authors.lastname: Pesenti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paolini
mesh_terms: D000328:Adult; D000368:Aged; D000475:Alkenes / Q000737:chemistry*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry; D010106:Oxygenators; D010107:Oxygenators, Membrane; D011108:Polymers / Q000494:pharmacology*; D011183:Postoperative Complications; D012770:Shock, Cardiogenic / Q000188:drug therapy*
chemical_list: D000475:Alkenes; D011108:Polymers; D010100:Oxygen