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Development of the oxygenator: past, present, and future
Hidehiko Iwahashi1, Koichi Yuri, Yukihiko Nosé
1Michael E. DeBakey Department of Surgery, Division for Transplant and Assist Devices, Center for Artificial Organ Development, Baylor College of Medicine, Houston, TX, USA. hiwahasi@siren.ocn.ne.jp
Summary
Membrane oxygenators are now preferred over bubble oxygenators for cardiopulmonary bypass due to their smaller priming volume and reduced blood trauma. Capillary oxygenators now use extracapillary blood perfusion to minimize hemolysis.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
Background:
- Bubble oxygenators dominated clinical use from the 1950s-1980s.
- Membrane oxygenators have become the preferred technology in the United States for cardiopulmonary bypass.
Observation:
- Membrane oxygenators offer comparable oxygenation to bubble and film types.
- They require less priming volume for efficient gas transfer.
- Their mechanism mimics the natural lung, reducing blood trauma like hemolysis.
Findings:
- Early capillary oxygenators (1980s) with intracapillary blood perfusion faced issues with high pressure resistance and hemolysis.
- Current capillary oxygenators utilize extracapillary blood perfusion to mitigate these problems.
- Microporous hollow-fiber membranes suit short-term cardiopulmonary bypass, while nonmicroporous membranes are used for long-term extracorporeal membrane oxygenation.
Implications:
- The shift to membrane oxygenators signifies advancements in patient safety and procedural efficiency.
- Optimized designs in capillary oxygenators enhance biocompatibility and reduce complications.
- The selection of membrane type (microporous vs. nonmicroporous) is critical for tailoring oxygenation strategies to specific clinical durations.