Experience with the Jostra Rotaflow and QuadroxD oxygenator for ECMO

Area of Science:

• Cardiovascular Surgery
• Critical Care Medicine
• Biomedical Engineering

Background:

• Extracorporeal membrane oxygenation (ECMO) provides vital cardiopulmonary support.
• Historically, spiral wound silicone-membrane oxygenators were primary, with early hollow-fiber devices showing limitations.
• Previous hollow-fiber oxygenators experienced early failure, necessitating device conversion.

Purpose of the Study:

• To evaluate the efficacy and application of the QuadroxD hollow-fiber oxygenator in ECMO.
• To assess the suitability of a single oxygenator device for diverse patient populations requiring ECMO.
• To determine if the new technology minimizes circuit changes and improves ECMO support availability.

Main Methods:

• Retrospective analysis of 23 patients (2.16-51.0 kg) supported with QuadroxD oxygenators from July 2000.
• Utilized poly-4-methyl-1-pentene diffusion membrane technology in the QuadroxD oxygenator.
• Documented duration of support, patient weight, and circuit management.

Main Results:

• The QuadroxD oxygenator facilitated continuous ECMO support for patients ranging from neonates to adults.
• Longest support duration achieved was 1119 hours with the QuadroxD device.
• The new nonmicroporous hollow-fiber membrane prevented plasma leakage, eliminating the need for circuit changeovers.

Conclusions:

• The QuadroxD oxygenator represents a significant advancement in ECMO technology.
• This device allows for a single, reliable oxygenator for all patient sizes, simplifying ECMO setup.
• Continuous availability of ECMO circuits and reduced circuit changes may improve patient survival and reduce morbidity.