Failure to oxygenate during cardiopulmonary bypass; treatment options and intervention algorithm

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Membrane oxygenator failure is a critical concern during cardiopulmonary bypass (CPB).
• Established protocols for oxygenator failure and staff practice are crucial for successful outcomes.
• A lack of a unified intervention algorithm for oxygenation failure during CPB exists.

Purpose of the Study:

• To address the lack of a unified intervention algorithm for membrane oxygenator failure during CPB.
• To introduce and evaluate the venous piggyback technique as a primary intervention.
• To enhance patient safety during CPB by providing temporizing measures.

Main Methods:

• Review of existing literature, including peer-reviewed articles, textbooks, and online resources.
• Identification of a lack of a standardized algorithm for oxygenator failure.
• Proposal and consideration of the venous piggyback technique as a first-line intervention.

Main Results:

• A gap in standardized protocols for managing oxygenator failure during CPB was identified.
• The venous piggyback technique is proposed as a viable first-line intervention.
• This technique can provide critical time for clinical teams to manage oxygenator failure.

Conclusions:

• The venous piggyback technique serves as a valuable first-line intervention for membrane oxygenator failure during CPB.
• This approach enhances patient safety by offering a temporizing measure.
• It allows clinical teams adequate time to determine necessary interventions, potentially avoiding immediate device change-out.