A prospective randomized study of membrane versus bubble oxygenators in children

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Pediatric Critical Care

Background:

• Cardiopulmonary bypass (CPB) is essential for pediatric cardiac surgery.
• Oxygenator selection impacts patient outcomes.
• Membrane and bubble oxygenators are common CPB technologies.

Purpose of the Study:

• To compare the physiological effects of membrane versus bubble oxygenators in children undergoing cardiac operations.
• To evaluate organ function and hematological parameters between the two oxygenator types.
• To determine the optimal criteria for selecting oxygenators in pediatric CPB.

Main Methods:

• Prospective study of 60 children (2 weeks to 10 years old) undergoing cardiac surgery.
• Random assignment to either a SciMed membrane oxygenator or Harvey bubble oxygenator.
• Controlled CPB variables (prime, circuit, flow, blood gases) and measured 302 variables including organ function and hematological parameters.

Main Results:

• No significant differences (p > 0.05) were observed in CPB variables or pulmonary, renal, and cerebral organ function between the groups.
• Hematological analysis revealed significantly lower free hemoglobin levels in the membrane oxygenator group at 5 and 60 minutes of CPB and postoperatively (p < 0.05).
• No differences noted in postoperative blood loss, fever, or hospitalization length.

Conclusions:

• Physiological outcomes and organ function are comparable between membrane and bubble oxygenators in pediatric CPB.
• Membrane oxygenators demonstrate an advantage in reducing intraoperative free hemoglobin.
• Decision-making for oxygenator choice in pediatric cardiac surgery should prioritize safety, cost, and convenience over solely physiological differences.