Bubble and membrane oxygenators--comparison of postoperative organ dysfunction with special reference to inflammatory...

Bubble and membrane oxygenators (2 types of each) were compared in a randomized study of 96 patients undergoing coronary bypass grafting. Cardiac performance, assessed from postoperative need of inotropic support, was significantly better in the membrane oxygenator group. After perfusion lasting more than 2 hours, respiratory function, measured as alveolar-arterial oxygen pressure gradient, was less compromised in that group and renal function, quantified as postoperative rise of serum creatinine was less disturbed. Cerebral function, studied in terms of psychometric test results and concentration of adenylate kinase in cerebrospinal fluid, did not differ between the bubble and membrane oxygenator groups. In investigations concerning changes in inflammatory activity during bypass, complement activation could not be related to the mentioned clinical parameters. Release of the neutrophil granulocyte factors lactoferrin and myeloperoxidase was greater in the bubble oxygenator group and correlated to impaired cardiac and renal performance, but not to pulmonary or cerebral dysfunction.