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Hematologic responses to prolonged extracorporeal circulation (ECC) with microporous membrane devices.

R H Bartlett, S W Fong, C Woldanski

Transactions - American Society for Artificial Internal Organs

|January 1, 1975

Summary

Microporous membrane oxygenators cause thrombocytopenia and decreased platelet function during prolonged cardiopulmonary bypass. These effects are similar to solid membranes, suggesting surface renewal, not material type, causes harm.

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Area of Science:

Biomedical Engineering
Cardiovascular Science
Hematology

Background:

Prolonged extracorporeal support requires efficient blood oxygenation.
Previous studies utilized solid silicone rubber membrane oxygenators.
The biocompatibility of microporous membranes for extended use needed evaluation.

Purpose of the Study:

To assess the hematological effects of veno-arterial bypass using microporous membrane oxygenators.
To compare these effects with those of solid silicone rubber membrane oxygenators.
To investigate the cause of blood-related complications during extracorporeal circulation.

Main Methods:

Veno-arterial bypass was established for 24–48 hours using microporous membrane oxygenators.
Platelet count and function were monitored.

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Clotting factors, fibrinogen, fibrinolytic system, white blood cell count, and plasma hemoglobin were analyzed.

Main Results:

Moderate progressive thrombocytopenia and decreased platelet function were observed.
No significant changes were noted in clotting factors, fibrinogen, or the fibrinolytic system.
Minimal alterations in white blood cell counts and plasma hemoglobin levels occurred.

Conclusions:

Microporous membrane oxygenators are suitable for prolonged extracorporeal support.
Hematological effects are comparable to solid silicone rubber membranes.
Blood-surface interactions, specifically continuous surface renewal, likely cause deleterious effects, not the interface material itself.