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The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 386-396, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
LK von Segesser and M Turina
Performance characteristics of heparin-coated hollow-fiber membrane
oxygenators (COATED HFMO, n = 5) were evaluated in an open-chest dog model
without systemic heparinization. Four other oxygenators were evaluated with
standard systemic heparinization (300 IU/kg, activated clotting time more
than 400 seconds): a standard hollow-fiber membrane oxygenator (HFMO, n =
5), an inversed hollow-fiber membrane oxygenator (IHFMO, n = 5), a plate
membrane oxygenator (PLATE MO, n = 5) and a bubble oxygenator (BUBBLE O, n
= 5). The 25 dogs (36 +/- 12 kg) were perfused after cavo-aortic
cannulation for 6 hours with a mean flow of 100 ml/kg body weight. At the
end of perfusion without systemic heparin, heparin-coated equipment was
replaced in three animals with standard uncoated equipment for control
studies. Besides continuous hemodynamic evaluation with Mikro-Tip pressure
transducers (Millar Instruments, Inc., Houston, Texas), a standard battery
of analyses was performed before, after mixing, and every 30 minutes during
bypass. All animals could be perfused in accordance with the protocol.
Blood-gas values (pH, arterial oxygen tension, and arterial carbon dioxide
tension) were maintained within physiologic ranges for all groups. After 6
hours of perfusion, plasma hemoglobin levels were as follows: 0.57 +/- 0.51
gm/L for COATED HFMO without systemic heparinization versus 2.65 +/- 1.02
gm/L for HFMO (p less than 0.05), 1.77 +/- 0.48 gm/L for IHFMO (p less than
0.05), 1.96 +/- 0.41 gm/L for PLATE O (p less than 0.05), and 1.5 +/- 0.40
gm/L for BUBBLE O (p less than 0.05) with systemic heparinization. Platelet
levels were highest for COATED HFMO with 47% +/- 36% without systemic
heparinization versus 33% +/- 9% for HFMO, 12% +/- 2% for IHFMO, 36% +/-
17% for PLATE O, and 19% +/- 12% for BUBBLE O with systemic heparinization.
Activated clotting time for COATED HFMO without systemic heparinization was
135 +/- 75 seconds before bypass, 207 +/- 21 seconds after mixing, and 131
+/- 20 seconds after 4 hours of perfusion. There was no statistically
significant increase of plasma heparin levels in the group perfused without
systemic heparin. Determination of fibrin split products during perfusion
without systemic heparinization did not show a significant increase. At the
end of perfusion all devices were disconnected and gently rinsed with
saline: There were no macroscopic clots in the COATED HFMO group perfused
without systemic heparin. However, uncoated equipment introduced for
control in animals perfused without systemic heparin showed major
clotting.(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Cardiopulmonary bypass without systemic heparinization. Performance of heparin-coated oxygenators in comparison with classic membrane and bubble oxygenators
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
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