Clinical experience with Affinity Pixie oxygenation system in paediatric and infant patients.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Pediatric Cardiology

Background:

• Over 500 pediatric open-heart surgeries requiring cardiopulmonary bypass are performed annually at Great Ormond Street Hospital.
• Neonatal and pediatric patients often necessitate higher cardiac indexes than previously recognized.
• The study evaluated the Pixie oxygenation system's suitability for these patient populations.

Purpose of the Study:

• To assess the efficacy of the Pixie oxygenation system in pediatric cardiopulmonary bypass.
• To determine the percentage of congenital cardiac defect procedures manageable with the Pixie oxygenator.
• To evaluate the system's performance regarding oxygenation, pressure drop, and gaseous microemboli handling.

Main Methods:

• A retrospective analysis of 250 consecutive patients undergoing congenital cardiac defect correction between 2010 and 2012.
• Data collected included FiO2 requirements, oxygenator pressure drop, and gaseous microemboli handling.
• Retrospective analysis of procedures and demographics from 2011-2012 identified patient suitability.

Main Results:

• The Pixie oxygenator is suitable for 89% of surgical procedures, primarily in patients under 20 kg requiring flow rates below 2 L/min.
• Maximum FiO2 requirement was 85% at 2.5 L/min.
• Gaseous microemboli were reduced by 82.5±9.9%, and bubble volume decreased by 94.3±8.4%.

Conclusions:

• The Pixie oxygenator is effective up to 2.5 L/min with air-handling capabilities comparable to existing systems.
• It can potentially serve 89% of the hospital's surgical procedures.
• For the smallest patients (<2 kg), a smaller priming oxygenator is advised to prevent excessive hemodilution.