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Thrombus formation and microaggregate removal during extracorporeal membrane oxygenation
Journal of Biomedical Materials Research
|March 1, 1979
Summary
Thrombus formation can still occur in modern membrane oxygenators despite adequate anticoagulation. Blood filtration from the cardiotomy reservoir may be crucial for reducing this thrombotic material in extracorporeal circuits.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Materials Science
Background:
- Contemporary microporous membrane oxygenators offer good gas transfer and are less traumatic to blood than older devices.
- Despite heparinization, thrombus formation remains a challenge in membrane oxygenators during cardiopulmonary bypass.
Purpose of the Study:
- To investigate the extent and location of thrombus formation in clinical membrane oxygenators.
- To identify potential sources of thrombotic material within the extracorporeal circuit.
Main Methods:
- Scanning electron microscopy was used to examine membrane oxygenators and filters post-use.
- Devices were analyzed from patients undergoing aorto-coronary bypass and cardiac valve replacement surgeries.
Main Results:
- Membrane surfaces were largely free of significant deposits.
- Thrombotic material was observed in other parts of the oxygenators and associated filters.
- Cardiotomy reservoir filtration appeared critical in reducing thrombus formation.
Conclusions:
- While membrane surfaces remain relatively clean, thrombus formation persists in extracorporeal circuits.
- Filtering blood from the cardiotomy reservoir is important for minimizing thrombus.
- Arterial filters are primarily effective as bubble removers, with limited impact on microemboli removal.