title: Evaluation of oxygenators and centrifugal pumps for long-term pediatric extracorporeal membrane oxygenation.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. amrit.thiara@rikshospitalet.no
authors.forename: A P S
authors.initials: AP
authors.lastname: Thiara
authors.forename: T N
authors.initials: TN
authors.lastname: Hoel
authors.forename: F
authors.initials: F
authors.lastname: Kristiansen
authors.forename: H M
authors.initials: HM
authors.lastname: Karlsen
authors.forename: A E
authors.initials: AE
authors.lastname: Fiane
authors.forename: J L
authors.initials: JL
authors.lastname: Svennevig
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D006454:Hemoglobins; D000990:Antithrombin III