Initial clinical experience with the admiral oxygenator combined with separated suction.
The Admiral, a new microporous membrane oxygenator with a low surface area, decreased priming volume and two separate reservoirs, was tested in 30 adult patients. This study was undertaken to evaluate blood path resistance, gas exchange capabilities and blood trauma in clinical use, with and without shed blood separation. Patients were divided into 3 groups. Group 1 had valve surgery without separation of suction, Group 2 had coronary artery bypass grafting (CABG) with direct blood aspiration and Group 3 had coronary artery bypass grafting with shed blood separation. The suctioned, separated, cardiotomy blood in Group 3 was treated with an autotransfusion device at the end of bypass before being returned to the patient. Theoretical blood flow could be achieved in all cases without problem. The pressure drop through the oxygenator averaged 88 +/- 13 mmHg at 4 l/min and 109 +/- 12 mmHg at 5 l/min. O(2) transfer was 163 +/- 27 ml/min. Free plasma haemoglobin rose in all groups, but significantly less in group 3. Lactate dehydrogenase (LDH) rose significantly in Groups 1 and 2. Platelets decreased in all groups without significant differences. Clinical experience with this new oxygenator was safe, the reduced membrane surface did not impair gas exchange and blood trauma could be minimized easily by separating shed blood, using the second cardiotomy reservoir.
De Stefano
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Department of Cardio-vascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. eleonora.de-stefano@chuv.ch
Delay
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Horisberger
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von Segesser
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D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004867:Equipment Design; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D010100:Oxygen / Q000097:blood*; D010107:Oxygenators, Membrane; D011312:Pressure; D013396:Suction / Q000295:instrumentation*
D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase; D010100:Oxygen