Additional veno-venous gas exchange as a problem-solving strategy for an oxygenator not transferring oxygen in paediatric cardiopulmonary bypass
Abstract OBJECTIVES Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described. METHODS A supplementary oxygenator is added in the venous lin...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2017-11, Vol.25 (5), p.687-689 |
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| creator | Boettcher, Wolfgang Sinzobahamvya, Nicodème Dehmel, Frank Matschke, Andreas Iben, Andre Cho, Mi-Young Redlin, Mathias Photiadis, Joachim |
| description | Abstract
OBJECTIVES
Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described.
METHODS
A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure.
RESULTS
On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator (n = 4) and Capiox FX15 (n = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min. Hypoxia ensued with partial oxygen pressure values of 49–79 mmHg with a fraction of inspired oxygen of 1. An additional veno-venous Terumo Capiox FX 05 oxygenator immediately improved oxygenation with resulting partial oxygen pressure increasing to at least 291 mmHg.
CONCLUSIONS
An additional veno-venous oxygenator effectively corrects failing oxygenator during cardiopulmonary bypass. The method does not require circulation arrest. It does not carry the risk of air embolism. It can be carried out without any help from a second perfusionist or member of operation team. |
| doi_str_mv | 10.1093/icvts/ivx192 |
| format | Article |
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OBJECTIVES
Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described.
METHODS
A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure.
RESULTS
On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator (n = 4) and Capiox FX15 (n = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min. Hypoxia ensued with partial oxygen pressure values of 49–79 mmHg with a fraction of inspired oxygen of 1. An additional veno-venous Terumo Capiox FX 05 oxygenator immediately improved oxygenation with resulting partial oxygen pressure increasing to at least 291 mmHg.
CONCLUSIONS
An additional veno-venous oxygenator effectively corrects failing oxygenator during cardiopulmonary bypass. The method does not require circulation arrest. It does not carry the risk of air embolism. It can be carried out without any help from a second perfusionist or member of operation team.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivx192</identifier><identifier>PMID: 29049743</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Blood Gas Analysis ; Cardiopulmonary Bypass - methods ; Child ; Child, Preschool ; Embolism, Air - prevention & control ; Equipment Design ; Female ; Heart Defects, Congenital - blood ; Heart Defects, Congenital - surgery ; Heart-Lung Machine ; Humans ; Male ; Oxygenators, Membrane ; Practice Guidelines as Topic</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2017-11, Vol.25 (5), p.687-689</ispartof><rights>The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2017</rights><rights>The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-d46b9d41a98e942678b6b7f8cf33386aaa887b59b286145ee43a3f50ce98231a3</citedby><cites>FETCH-LOGICAL-c361t-d46b9d41a98e942678b6b7f8cf33386aaa887b59b286145ee43a3f50ce98231a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1598,27901,27902</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/icvts/ivx192$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29049743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boettcher, Wolfgang</creatorcontrib><creatorcontrib>Sinzobahamvya, Nicodème</creatorcontrib><creatorcontrib>Dehmel, Frank</creatorcontrib><creatorcontrib>Matschke, Andreas</creatorcontrib><creatorcontrib>Iben, Andre</creatorcontrib><creatorcontrib>Cho, Mi-Young</creatorcontrib><creatorcontrib>Redlin, Mathias</creatorcontrib><creatorcontrib>Photiadis, Joachim</creatorcontrib><title>Additional veno-venous gas exchange as a problem-solving strategy for an oxygenator not transferring oxygen in paediatric cardiopulmonary bypass</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>Abstract
OBJECTIVES
Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described.
METHODS
A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure.
RESULTS
On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator (n = 4) and Capiox FX15 (n = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min. Hypoxia ensued with partial oxygen pressure values of 49–79 mmHg with a fraction of inspired oxygen of 1. An additional veno-venous Terumo Capiox FX 05 oxygenator immediately improved oxygenation with resulting partial oxygen pressure increasing to at least 291 mmHg.
CONCLUSIONS
An additional veno-venous oxygenator effectively corrects failing oxygenator during cardiopulmonary bypass. The method does not require circulation arrest. It does not carry the risk of air embolism. It can be carried out without any help from a second perfusionist or member of operation team.</description><subject>Blood Gas Analysis</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Embolism, Air - prevention & control</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Heart Defects, Congenital - blood</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart-Lung Machine</subject><subject>Humans</subject><subject>Male</subject><subject>Oxygenators, Membrane</subject><subject>Practice Guidelines as Topic</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9P3DAQxS3UCihw41z51h4asGMnax8Ron8kJC7lHE2cSXCV2KntrHa_BR8ZL6Ece7HHmp_ejN8j5JKzK860uLZmm-K13e64Lo_IKa9qXehSVR_eay1OyKcY_zDGNRPsmJyUmkm9keKUPN90nU3WOxjpFp0vDscS6QCR4s48gRuQ5hroHHw74lREP26tG2hMARIOe9r7QMFRv9sP6CDll_OJ5q6LPYZwYNcetY7OgJ2FFKyhBkJn_byMU54e9rTdzxDjOfnYwxjx4u0-I4_f737f_izuH378ur25L4yoeSo6Wbe6kxy0Qi3LeqPaut30yvRCCFUDgFKbttJtqWouK0QpQPQVM6hVKTiIM_J11c3_-rtgTM1ko8FxBIfZgIbrSrJaVkpl9NuKmuBjDNg3c7BTXrnhrDlk0Lxm0KwZZPzzm_LSTti9w_9Mz8CXFfDL_H-pF7qClfY</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Boettcher, Wolfgang</creator><creator>Sinzobahamvya, Nicodème</creator><creator>Dehmel, Frank</creator><creator>Matschke, Andreas</creator><creator>Iben, Andre</creator><creator>Cho, Mi-Young</creator><creator>Redlin, Mathias</creator><creator>Photiadis, Joachim</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171101</creationdate><title>Additional veno-venous gas exchange as a problem-solving strategy for an oxygenator not transferring oxygen in paediatric cardiopulmonary bypass</title><author>Boettcher, Wolfgang ; Sinzobahamvya, Nicodème ; Dehmel, Frank ; Matschke, Andreas ; Iben, Andre ; Cho, Mi-Young ; Redlin, Mathias ; Photiadis, Joachim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-d46b9d41a98e942678b6b7f8cf33386aaa887b59b286145ee43a3f50ce98231a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood Gas Analysis</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Embolism, Air - prevention & control</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Heart Defects, Congenital - blood</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart-Lung Machine</topic><topic>Humans</topic><topic>Male</topic><topic>Oxygenators, Membrane</topic><topic>Practice Guidelines as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boettcher, Wolfgang</creatorcontrib><creatorcontrib>Sinzobahamvya, Nicodème</creatorcontrib><creatorcontrib>Dehmel, Frank</creatorcontrib><creatorcontrib>Matschke, Andreas</creatorcontrib><creatorcontrib>Iben, Andre</creatorcontrib><creatorcontrib>Cho, Mi-Young</creatorcontrib><creatorcontrib>Redlin, Mathias</creatorcontrib><creatorcontrib>Photiadis, Joachim</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Boettcher, Wolfgang</au><au>Sinzobahamvya, Nicodème</au><au>Dehmel, Frank</au><au>Matschke, Andreas</au><au>Iben, Andre</au><au>Cho, Mi-Young</au><au>Redlin, Mathias</au><au>Photiadis, Joachim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Additional veno-venous gas exchange as a problem-solving strategy for an oxygenator not transferring oxygen in paediatric cardiopulmonary bypass</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>25</volume><issue>5</issue><spage>687</spage><epage>689</epage><pages>687-689</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>Abstract
OBJECTIVES
Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described.
METHODS
A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure.
RESULTS
On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator (n = 4) and Capiox FX15 (n = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min. Hypoxia ensued with partial oxygen pressure values of 49–79 mmHg with a fraction of inspired oxygen of 1. An additional veno-venous Terumo Capiox FX 05 oxygenator immediately improved oxygenation with resulting partial oxygen pressure increasing to at least 291 mmHg.
CONCLUSIONS
An additional veno-venous oxygenator effectively corrects failing oxygenator during cardiopulmonary bypass. The method does not require circulation arrest. It does not carry the risk of air embolism. It can be carried out without any help from a second perfusionist or member of operation team.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29049743</pmid><doi>10.1093/icvts/ivx192</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Blood Gas Analysis Cardiopulmonary Bypass - methods Child Child, Preschool Embolism, Air - prevention & control Equipment Design Female Heart Defects, Congenital - blood Heart Defects, Congenital - surgery Heart-Lung Machine Humans Male Oxygenators, Membrane Practice Guidelines as Topic |
| title | Additional veno-venous gas exchange as a problem-solving strategy for an oxygenator not transferring oxygen in paediatric cardiopulmonary bypass |
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