Initial clinical experience with the admiral oxygenator combined with separated suction

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Medical Devices

Background:

• The Admiral is a novel microporous membrane oxygenator designed with a low surface area, reduced priming volume, and dual reservoirs.
• Evaluating new cardiopulmonary bypass equipment is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the clinical performance of the Admiral oxygenator.
• To evaluate blood path resistance, gas exchange, and blood trauma during cardiopulmonary bypass.
• To compare outcomes with and without shed blood separation.

Main Methods:

• The study involved 30 adult patients undergoing cardiac surgery, divided into three groups based on surgical procedure and blood management.
• Group 1: Valve surgery without suction separation. Group 2: Coronary Artery Bypass Grafting (CABG) with direct blood aspiration. Group 3: CABG with shed blood separation and autotransfusion.
• Hemodynamic parameters, gas exchange, and markers of blood trauma (free plasma hemoglobin, lactate dehydrogenase, platelets) were measured.

Main Results:

• The Admiral oxygenator achieved theoretical blood flow without issues, with pressure drops of 88 +/- 13 mmHg at 4 L/min and 109 +/- 12 mmHg at 5 L/min.
• Oxygen transfer averaged 163 +/- 27 ml/min.
• Free plasma hemoglobin increased in all groups but was significantly lower in Group 3. Lactate dehydrogenase levels rose significantly in Groups 1 and 2. Platelet counts decreased across all groups without significant inter-group differences.

Conclusions:

• The Admiral oxygenator is safe for clinical application in cardiopulmonary bypass.
• Its reduced membrane surface area does not impede gas exchange efficiency.
• Separating shed blood using the dual-reservoir system effectively minimizes blood trauma, offering a significant advantage in patient care.