Key result
All evaluated adult v-v ECMO systems produced adequate blood flow without an increased risk of technical-induced hemolysis, despite differences in pump speed and pressure drop.
Why the study?
Do different adult v-v ECMO systems differ in flow dynamics and risk of technical-induced hemolysis in patients with acute lung failure?
Observational (n=186)
Do different adult v-v ECMO systems differ in flow dynamics and risk of technical-induced hemolysis in patients with acute lung failure?
Answers are grounded in this paper and cite their sources.
Commercially available adult v-v ECMO systems provide adequate blood flow without increased hemolysis risk, though specific flow dynamics and pressure drops vary by system.
Membrane oxygenator (MO) failure is a known hazard during venovenous extracorporeal membrane oxygenation (v-v ECMO) therapy. Knowledge about technical and performance details of different ECMO systems (Maquet, Rastatt, Germany; Medos, Stolberg, Germany; Sorin, Modena, Italy) licensed for adults with acute lung failure might improve their handling. This retrospective study comprises 186 adult patients (Regensburg ECMO Registry) treated with v-v ECMO. Flow dynamic data were used to analyze the performance of different blood pumps, cannula types, and MOs to maintain an adequate blood flow (1-5 L/min). Usage of the Medos ECMO system in critically ill patients required a higher pump speed and generated a higher pressure drop across the MO (dpMO), however, without an increase in free plasma hemoglobin. The dpMO depended on the type of MO and increased with blood flow as expected. Type-specific normal values are reported. A distinct increase in dpMO above normal values within 1 day required an immediate MO exchange. This was an infrequent technical complication (3%). Finally, pressure-flow performance of single dual-lumen cannulas (27 Fr) was comparable with small single-lumen cannulas (15 Fr), without an increased risk of technical-induced hemolysis. Despite different performances, all current commercially available adult v-v ECMO systems produce adequate blood flow without an increased risk in technical-induced hemolysis. Familiarity with the specific properties of individual systems allows early detection of technical complications. Additionally, the choice of an adequate cannula requires a closer consideration of the individual patient situation.
No takes yet. Share an insight, caveat, or question.
Lehle et al. (2013) conducted an observational in Acute lung failure requiring v-v ECMO (n=186). Different v-v ECMO systems (Maquet, Medos, Sorin) was evaluated on Flow dynamic data (performance of blood pumps, cannula types, and membrane oxygenators to maintain adequate blood flow). All evaluated adult v-v ECMO systems produced adequate blood flow without an increased risk of technical-induced hemolysis, despite differences in pump speed and pressure drop.
Synapse has enriched 10 related papers. Consider them for comparative context: