Rethinking the AAMI/ISO 'International Standard' for oxygen transfer performance of artificial lungs

We believe we have fulfilled the five objectives outlined in the introductory section to this text. Unquestionably, the clinical perfusionist will be confronted with a set of conditions that do not match the very specific values proposed for our in vitro performance testing. The in vitro results for a particular brand of oxygenator can serve as a 'performance baseline', predicting oxygen transfer performance under standard conditions. It is encumbant upon the clinical perfusionist to assess the impact that each variable (i.e. Hb, blood flow and SvO2) will have on the overall oxygen transfer performance. Table 5 illustrates how increases or decreases in each of these three variables can influence the resulting VO2/minute. The clinical perfusionist must manipulate these variables in order to satisfy the oxygen transfer demand created by the patient on CPB. In order for the in vitro performance testing to be helpful in the clinical environment, the perfusionist must: (1) be familiar with the results and the conditions under which they were achieved; and (2) be able to assess and interpret how their current set of conditions on cardiopulmonary bypass will impact on the oxygenator's performance. Example Brand Y membrane oxygenator is being used clinically on a patient weighing 115 kg and consuming 320 ml O2/minute. According to Table 4, this VO2/minute exceeds the 277.2 ml O2/minute achieved during its in vitro performance test.(ABSTRACT TRUNCATED AT 250 WORDS)