PDF herunterladen
J Pediatr Intensive Care 2018; 07(01): 007-013
DOI: 10.1055/s-0037-1599150
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Hollow Fiber Oxygenator Composition Has a Significant Impact on Failure Rates in Neonates on Extracorporeal Membrane Oxygenation: A Retrospective Analysis

John M. Daniel IV
1   Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States
,
Philip A. Bernard
2   Division of Pediatric Critical Care, Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States
,
Sean C. Skinner
3   Division of Pediatric Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky, United States
,
Prasad Bhandary
1   Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States
,
Ana Ruzic
3   Division of Pediatric Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky, United States
,
Matthew K. Bacon
2   Division of Pediatric Critical Care, Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States
,
Hubert O. Ballard
1   Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

07. Dezember 2016

22. Januar 2017

Publikationsdatum:
07. März 2017 (online)

    Lizenzen und Reprints

Abstract

In extracorporeal life support (ECLS), there are two main types of oxygenators in clinical use for neonates: polymethylpentene (PMP) hollow fiber and polypropylene (PP) hollow fiber. A retrospective study was performed on neonates (n = 44) who had undergone ECLS for noncardiac indications from 2009 to 2015. Between the two groups (PMP n = 21, PP n = 23), the PP oxygenators failed 91% of the time, whereas the PMP oxygenators failed 43% of the time (p < 0.05). Analysis suggests PMP oxygenators are less prone to failure than PP oxygenators, and they require fewer number of oxygenator changes during a neonatal ECLS.

Keywords

extracorporeal membrane oxygenation - neonatal - oxygenator - complications
 

  • References

  • 1 Rycus P. Re: ELSO Database Question. Message to John Daniel; 2016
    Google Scholar
  • 2 Fuhrman BP. Pediatric Critical care. 4th ed. Philadelphia, PA: Elsevier Saunders; 2011
    Google Scholar
  • 3 Wickramasinghe SR, Han B. Designing microporous hollow fibre blood oxygenators. Chem Eng Res Des 2005; 83 (03) 256-267
    CrossrefPubMedGoogle Scholar
  • 4 Shimono T, Shomura Y, Hioki I. , et al. Silicone-coated polypropylene hollow-fiber oxygenator: experimental evaluation and preliminary clinical use. Ann Thorac Surg 1997; 63 (06) 1730-1736
    CrossrefPubMedGoogle Scholar
  • 5 Puis L, Ampe L, Hertleer R. Case report: plasma leakage in a polymethylpentene oxygenator during extracorporeal life support. Perfusion 2009; 24 (01) 51-52
    CrossrefPubMedGoogle Scholar
  • 6 Lehle K, Philipp A, Gleich O. , et al. Efficiency in extracorporeal membrane oxygenation-cellular deposits on polymethylpentene membranes increase resistance to blood flow and reduce gas exchange capacity. ASAIO J 2008; 54 (06) 612-617
    CrossrefPubMedGoogle Scholar
  • 7 Talor J, Yee S, Rider A, Kunselman AR, Guan Y, Undar A. Comparison of perfusion quality in hollow-fiber membrane oxygenators for neonatal extracorporeal life support. Artif Organs 2010; 34 (04) E110-E116
    CrossrefPubMedGoogle Scholar
  • 8 Haines NM, Rycus PT, Zwischenberger JB, Bartlett RH, Undar A. Extracorporeal Life Support Registry Report 2008: neonatal and pediatric cardiac cases. ASAIO J 2009; 55 (01) 111-116
    CrossrefPubMedGoogle Scholar
  • 9 Khoshbin E, Dux AE, Killer H, Sosnowski AW, Firmin RK, Peek GJ. A comparison of radiographic signs of pulmonary inflammation during ECMO between silicon and poly-methyl pentene oxygenators. Perfusion 2007; 22 (01) 15-21
    CrossrefPubMedGoogle Scholar
  • 10 Khoshbin E, Westrope C, Pooboni S. , et al. Performance of polymethyl pentene oxygenators for neonatal extracorporeal membrane oxygenation: a comparison with silicone membrane oxygenators. Perfusion 2005; 20 (03) 129-134
    CrossrefPubMedGoogle Scholar
  • 11 Robak O, Lakatos PK, Bojic A. , et al. Influence of different oxygenator types on changing frequency, infection incidence, and mortality in ARDS patients on veno-venous ECMO. Int J Artif Organs 2014; 37 (11) 839-846
    CrossrefPubMedGoogle Scholar
  • 12 Paden ML, Rycus PT, Thiagarajan RR, Registry E. ; ELSO Registry. Update and outcomes in extracorporeal life support. Semin Perinatol 2014; 38 (02) 65-70
    CrossrefPubMedGoogle Scholar
  • 13 Khoshbin E, Roberts N, Harvey C. , et al. Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation. ASAIO J 2005; 51 (03) 281-287
    CrossrefPubMedGoogle Scholar
  • 14 Barrett CS, Jaggers JJ, Cook EF. , et al. Outcomes of neonates undergoing extracorporeal membrane oxygenation support using centrifugal versus roller blood pumps. Ann Thorac Surg 2012; 94 (05) 1635-1641
    CrossrefPubMedGoogle Scholar