title: Malfunction of the extracorporeal circulation system: case report.
abstract: OBJECTIVE
  The introduction of extracorporeal circulation in clinical practice was decisive for the development of modern cardiovascular surgery. Addition of new procedures and equipment, however, brings inherent risks and complications. The objective of this report is to describe a malfunction of the oxygenation system and emphasize the importance of the interaction among the medical team members to prevent errors and complications.
  
  
  METHODS
  During valve replacement and IVC correction surgery, we observed a darker shade of red in the blood on the exit of the oxygenator. Laboratory tests demonstrated severe acidosis and hypoxemia. The entire system was evaluated, but the cause of the malfunction was not found. Measures to reduce damage were successfully instituted. After the surgery, the whole system underwent technical evaluation.
  
  
  CONCLUSIONS
  Interaction among the medical team members, early diagnosis, and immediate intervention were fundamental for a favorable outcome.
authors: Universidade de São Paulo, Sao Paulo, Brazil. cedalmeida@terra.com.br
authors: Carlos Eduardo David
authors: CE
authors: de Almeida
authors: Antônio Roberto
authors: AR
authors: Carraretto
authors: Erick Freitas
authors: EF
authors: Curi
authors: Louisie Marcelle da Silva Almeida
authors: LM
authors: Marques
authors: Roberta Eleni Monteiro
authors: RE
authors: Abatti
mesh_terms: D004868:Equipment Failure; D005112:Extracorporeal Circulation / Q000295:instrumentation*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged