Evaluation of oxygenators and centrifugal pumps for long-term pediatric extracorporeal membrane oxygenation.
OBJECTIVE
Two extracorporeal membrane oxygenation (ECMO) circuits for children under 10 kg were evaluated and compared for plasma leakage, hemolysis, blood transfusions, and durability.


METHODS
Group A (n=20) was supported by ECMO circuits with the Minimax oxygenator and the Biomedicus centrifugal pump. Group B (n=10) was supported by ECMO circuits with the Lilliput 2 ECMO oxygenator and the Rotaflow centrifugal pump.


RESULTS
ECMO circuit durability, as measured by oxygenator lifespan, was significantly better in Group B than in Group A (p = 0.04). There was significantly lower hemolysis, measured by plasma free hemoglobin, in Group B (p = 0.019), and patients in Group B had significantly less need for antithrombin III transfusion (p = 0.004). No plasma leakage was observed in Group B oxygenators, but plasma leakage was observed in all Group A oxygenators.


CONCLUSIONS
The combination of a Rotaflow centrifugal pump and Lilliput 2 ECMO oxygenator in pediatric ECMO circuits improved durability and reduced circuit-induced hemolysis. This improvement may be due to the low priming volume, the oxygenator's plasma leakage resistance, the suspended rotor of the centrifugal pump, or a combination of these factors.
Thiara
A P S
AP
Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. amrit.thiara@rikshospitalet.no
Hoel
T N
TN
Kristiansen
F
F
Karlsen
H M
HM
Fiane
A E
AE
Svennevig
J L
JL
D000925:Anticoagulants / Q000627:therapeutic use; D000990:Antithrombin III / Q000627:therapeutic use; D049628:Body Size; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006454:Hemoglobins; D006461:Hemolysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007260:Infusion Pumps; D008297:Male; D010949:Plasma; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D006454:Hemoglobins; D000990:Antithrombin III