Two membrane oxygenators and a bubbler: a clinical comparison.

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Hematology

Background:

• Oxygenators are crucial in cardiopulmonary bypass for cardiac surgery.
• Bubble oxygenators have been associated with higher rates of blood cell damage.
• Membrane oxygenators offer an alternative with potentially improved hemocompatibility.

Purpose of the Study:

• To compare the hemocompatibility of bubble versus membrane oxygenators.
• To evaluate the impact of different oxygenator types on hematological parameters.
• To correlate platelet function and blood cell damage with clinical outcomes.

Main Methods:

• A comparative study involving 43 patients undergoing aortic valve replacement.
• Hematological data collection in a subgroup of 27 patients.
• Assessment of blood loss, blood product requirements, platelet aggregation, and erythrocyte damage.

Main Results:

• Membrane oxygenators (SciMed, Travenol TMO) showed less platelet and erythrocyte damage than bubble oxygenators.
• No significant differences in blood loss or blood product requirements were found between oxygenator types.
• Leukocytosis was most pronounced in the SciMed group; platelet counts correlated negatively with bypass duration and blood loss.

Conclusions:

• Membrane oxygenators provide superior preservation of platelets and erythrocytes compared to bubble oxygenators.
• The Travenol TMO system may cause more erythrocyte damage than the SciMed system, potentially due to its dual-pump design.
• Clinical evidence of improved outcomes requires controlling other factors contributing to blood damage during cardiopulmonary bypass.