Technical aspects of plasma leakage prevention in microporous capillary membrane oxygenators

A limiting factor in using microporous capillary membrane oxygenators (CMO) for long-term extracorporeal lung support is leakage. Application of heparin-coated CMO requires additional examination because leakage is probably caused by the temperature conditions of the gas, the blood and the circuit environment, and the surface tension phenomenon at the micropores. The authors designed a thermostatized box in which the temperature of flowing gas (Tg) and blood (Tb), and the interior temperature of the box (Ti) could be regulated independently. Tb was adjusted to the animal's body temperature, and Tg was kept about 2 degrees C higher to prevent condensation of the evaporated fluid from the blood side, through the micropores, into the gas phase. Ti was maintained between Tg and Tb. The saturated outlet gas could therefore condense only outside the box. This system was used during 5 days of venovenous bypass using a covalently heparin-bonded (Carmeda) CMO (Maxima, Medtronic) in four adult sheep. No plasma leakage occurred, the surface tension of condensate water remained constant, and the gas exchange capacity of CMO was unchanged.