Related Experiment Videos
Oxygenator thrombosis: an international phenomenon
1Department of Perfusion, West Roxbury VA Hospital, Massachusetts, USA. schaadt@usw.com
Perfusion
|December 10, 1999
Summary
Oxygenator thrombosis during cardiopulmonary bypass (CPB) is a growing concern. This study reviews potential causes, emphasizing patient-specific hematological factors that may lead to this critical complication.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Biomedical Engineering
Background:
- Oxygenator thrombosis, a complication during cardiopulmonary bypass (CPB), is increasingly reported despite adequate anticoagulation.
- This phenomenon involves a rapid rise in oxygenator inlet pressure, potentially compromising gas exchange and necessitating device replacement.
- The exact etiology remains unknown, though platelet activation and fibrin deposition are hypothesized mechanisms.
Purpose of the Study:
- To review existing literature and case reports on oxygenator thrombosis during CPB.
- To explore potential contributing factors, including bypass techniques, equipment, medications, and patient-specific variables.
- To highlight the significance of patient hematology in the development of hypercoagulable states leading to thrombosis.
Main Methods:
- Comprehensive review of domestic and international publications and case reports on oxygenator thrombosis.
- Analysis of hypothesized mechanisms, including platelet activation and fibrin deposition.
- Examination of potential catalysts such as bypass techniques, equipment, pharmacological agents, prime composition, and patient factors.
Main Results:
- Oxygenator thrombosis presents as a transient increase in oxygenator inlet pressure shortly after CPB initiation.
- Thrombus formation can lead to shunting, impairing gas transfer and potentially requiring oxygenator exchange.
- Patient-specific hematological variables, including blood type, genetics, age, disease state, gender, and heparin response, are implicated as potential triggers for hypercoagulability.
Conclusions:
- Oxygenator thrombosis is a complex issue with multifactorial origins, requiring further investigation.
- Patient-specific hematological factors play a crucial role in provoking hypercoagulable states that contribute to thrombosis.
- Understanding these patient variables is essential for developing strategies to prevent and manage oxygenator thrombosis during CPB.