Evaluation of two pediatric polymethyl pentene membrane oxygenators with pulsatile and non-pulsatile perfusion.
OBJECTIVE
This experiment sought to compare two polymethyl pentene (PMP) hollow-fiber membrane oxygenators: the Medos HILITE 2400 LT and the Maquet Quadrox-iD Pediatric in terms of transmembrane pressure gradients and hemodynamic energy preservation under both pulsatile and non-pulsatile conditions.


METHODS
A simulated pediatric extracorporeal life support (ECLS) circuit was used to test these two oxygenators. The circuit consisted of a roller pump, ¼ inch tubing for both arterial and venous lines, an oxygenator, and a venous reservoir served as a pseudo-patient. Three pressure transducers were placed upstream and downstream of the oxygenator and the distal arterial line. The experimental system was primed with lactated Ringer's solution and packed human red blood cells to maintain a hematocrit of 40%.The total volume was 600 ml, including the 350 ml volume of the pseudo-patient.The tests were performed at six flow rates (250, 500, 750, 1000, 1250, 1500 ml/min) and three distal arterial line pressures (MAP) (60, 80, 100 mmHg), under both pulsatile and non-pulsatile perfusion modes.The temperature was kept constant at 37°C for all tests.


RESULTS
Both oxygenators had adequate performances in pressure drop and hemodynamic energy preservation. There were no significant differences between pre- and post-oxygenators for mean pressure (MP), energy equivalent pressure (EEP) and total hemodynamic energy (THE). During the pulsatile perfusion mode, the HILITE 2400 LT retained a greater percentage of surplus hemodynamic energy (SHE) across the oxygenator.


CONCLUSIONS
Both the Quadrox-iD Pediatric and HILITE 2400LT PMP membrane oxygenators are suitable for pediatric ECLS therapy under both non-pulsatile and pulsatile perfusion. An optimized combination of flow rate and MAP should be achieved in order to deliver the maximal pulsatile energy in the extracorporeal circuit.
Pediatric Cardiovascular Research Center, and Department of Pediatrics, Milton S. Hershey Medical Center, Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
Feng
F
Qiu
Sameer
S
Khan
Jonathan
J
Talor
Allan
A
Kunselman
Akif
A
Undar
D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008955:Models, Cardiovascular; D010107:Oxygenators, Membrane; D011673:Pulsatile Flow
D008567:Membranes, Artificial