Impact of Distinct Oxygenators on Pulsatile Energy Indicators in an Adult Cardiopulmonary Bypass Model.
The quantification of pulse energy during cardiopulmonary bypass (CPB) post-oxygenator is required prior to the evaluation of the possible beneficial effects of pulsatile flow on patient outcome. We therefore, evaluated the impact of three distinctive oxygenators on the energy indicators energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) in an adult CPB model under both pulsatile and laminar flow conditions. The pre- and post-oxygenator pressure and flow were measured at room temperature using a 40% glycerin-water mixture at flow rates of 1, 2, 3, 4, 5, and 6 L/min. The pulse settings at frequencies of 40, 50, 60, 70, and 80 beats per minute were according to the internal algorithm of the Sorin CP5 centrifugal pump. The EEP is equal to the mean pressure, hence no SHE is present under laminar flow conditions. The Quadrox-i Adult oxygenator was associated with the highest preservation of pulsatile energy irrespective of flow rates. The low pressure drop-high compliant Quadrox-i Adult oxygenator shows the best SHE performance at flow rates of 5 and 6 L/min, while the intermediate pressure drop-low compliant Fusion oxygenator and the high pressure drop-low compliant Inspire 8F oxygenator behave optimally at flow rates of 5 L/min and up to 4 L/min, respectively. In conclusion, our findings contributed to studies focusing on SHE values post-oxygenator as well as post-cannula in clinical practice. In addition, our findings may give guidance to the clinical perfusionist for oxygenator selection prior to pulsatile CPB based on the calculated flow rate for the individual patient.
Department of Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam.
Lonneke M
LM
Griep
Department of Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam.
Laurentius J M
LJ
van Barneveld
Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht.
Antoine P
AP
Simons
Department of Anesthesiology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
Christa
C
Boer
Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht.
Patrick W
PW
Weerwind
D000328:Adult; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D004867:Equipment Design; D006439:Hemodynamics; D006801:Humans; D008955:Models, Cardiovascular; D010107:Oxygenators, Membrane; D011312:Pressure; D011673:Pulsatile Flow
Centrifugal pump; Energy indicators; Oxygenator; Pulsatile flow