The type of aortic cannula and membrane oxygenator affect the pulsatile waveform morphology produced by a neonate-infant cardiopulmonary bypass system in vivo

Akif Ündar, Andrew J. Lodge, Casey W. Daggett, Thomas M. Runge, Ross M. Ungerleider, John H Calhoon

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Although the debate still continues over the effectiveness of pulsatile versus nonpulsatile perfusion, it has been clearly proven that there are several significant physiological benefits of pulsatile perfusion during cardiopulmonary bypass (CPB) compared to nonpulsatile perfusion. However, the components of the extracorporeal circuit have not been fully investigated regarding the quality of the pulsatility. In addition, most of these results have been gathered from adult patients, not from neonates and infants. We have designed and tested a neonate-infant pulsatile CPB system using 2 different types of 10 Fr aortic cannulas and membrane oxygenators in 3 kg piglets to evaluate the effects of these components on the pulsatile waveform produced by the system. In terms of the methods, Group 1 (Capiox 308 hollow- fiber membrane oxygenator and DLP aortic cannula with a very short 10 Fr tip [n = 2]) was subjected to a 2 h period of normothermic pulsatile CPB with a pump flow rate of 150 ml/kg/min. Data were obtained at 5, 30, 60, 90, and 120 min of CPB. In Group 2 (Capiox 308 hollow-fiber membrane oxygenator and Elecath aortic cannula with a very long 10 Fr tip [n = 7]) and Group 3 (Cobe VPCML Plus flat sheet membrane oxygenator and DLP aortic cannula with a very short 10 Fr tip [n = 7]), the subjects' nasopharyngeal temperatures were reduced to 18°C followed by 1 h of deep hypothermic circulatory arrest (DHCA) and then 40 min rewarming. Data were obtained during normothermic CPB in the pre- and post-DHCA periods. The criteria of pulsatility evaluations were based upon pulse pressure (between 30 and 40 mm Hg), aortic dp/dt (greater than 1000 mm Hg/s), and ejection time (less than 250 ms). The results showed that Group 1 produced flow which was significantly more pulsatile than that of the other 2 groups. Although the same oxygenator was used for Group 2, the quality of the pulsatile flow decreased when using a different aortic cannula. Group 3 did not meet any of the criteria for physiologic pulsatility. In conclusion these data suggest that in addition to a pulsatile pump, the aortic cannula and the membrane oxygenator must be chosen carefully to achieve physiologic pulsatile flow during CPB.

Original languageEnglish (US)
Pages (from-to)681-686
Number of pages6
JournalArtificial Organs
Volume22
Issue number8
DOIs
StatePublished - 1998

Fingerprint

Oxygenators
Membrane Oxygenators
Cardiopulmonary Bypass
Newborn Infant
Membranes
Pulsatile Flow
Deep Hypothermia Induced Circulatory Arrest
Pulsatile flow
Perfusion
Pumps
Rewarming
Fibers
Cannula
Flow rate
Blood Pressure
Temperature
Networks (circuits)

Keywords

  • Aortic cannula
  • Cardiopulmonary bypass
  • Extracorporeal circulation
  • Membrane oxygenator
  • Neonates and Infants
  • Pulsatile perfusion

ASJC Scopus subject areas

  • Biophysics

Cite this

The type of aortic cannula and membrane oxygenator affect the pulsatile waveform morphology produced by a neonate-infant cardiopulmonary bypass system in vivo. / Ündar, Akif; Lodge, Andrew J.; Daggett, Casey W.; Runge, Thomas M.; Ungerleider, Ross M.; Calhoon, John H.

In: Artificial Organs, Vol. 22, No. 8, 1998, p. 681-686.

Research output: Contribution to journalArticle

Ündar, Akif ; Lodge, Andrew J. ; Daggett, Casey W. ; Runge, Thomas M. ; Ungerleider, Ross M. ; Calhoon, John H. / The type of aortic cannula and membrane oxygenator affect the pulsatile waveform morphology produced by a neonate-infant cardiopulmonary bypass system in vivo. In: Artificial Organs. 1998 ; Vol. 22, No. 8. pp. 681-686.
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