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Functional performance of different venous limb options in simulated neonatal/pediatric cardiopulmonary bypass circuits
Caneo, Luiz Fernando; Matte, Gregory S; Guimarães, Daniel Peres; Viotto, Guilherme; Mazzeto, Marcelo; Cestari, Idagene; Neirotti, Rodolfo A; Jatene, Marcelo B; Wang, Shigang; Ündar, Akif; Chang Junior, João; Jatene, Fabio B.
  • Caneo, Luiz Fernando; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Matte, Gregory S; Boston Children's Hospital. Department of Cardiac Surgery. Boston. US
  • Guimarães, Daniel Peres; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Viotto, Guilherme; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Mazzeto, Marcelo; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Cestari, Idagene; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Neirotti, Rodolfo A; Emeritus Michigan State University. US
  • Jatene, Marcelo B; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Wang, Shigang; Penn State Health Children's Hospital. Penn State College of Medicine. Penn State Health Milton S. Hershey Medical Center. Hershey. US
  • Ündar, Akif; Penn State Health Children's Hospital. Penn State College of Medicine. Penn State Health Milton S. Hershey Medical Center. Hershey. US
  • Chang Junior, João; FEI University Center. Department of Industrial Engineering. São Paulo. BR
  • Jatene, Fabio B; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
Rev. bras. cir. cardiovasc ; 33(3): 224-232, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-958406
ABSTRACT
Abstract

Objective:

Hemodilution is a concern in cardiopulmonary bypass (CPB). Using a smaller dual tubing rather than a single larger inner diameter (ID) tubing in the venous limb to decrease prime volume has been a standard practice. The purpose of this study is to evaluate these tubing options.

Methods:

Four different CPB circuits primed with blood (hematocrit 30%) were investigated. Two setups were used with two circuits for each one. In Setup I, a neonatal oxygenator was connected to dual 3/16" ID venous limbs (Circuit A) or to a single 1/4" ID venous limb (Circuit B); and in Setup II, a pediatric oxygenator was connected to dual 1/4" ID venous limbs (Circuit C) or a single 3/8" ID venous limb (Circuit D). Trials were conducted at arterial flow rates of 500 ml/min up to 1500 ml/min (Setup I) and up to 3000 ml/min (Setup II), at 36°C and 28°C.

Results:

Circuit B exhibited a higher venous flow rate than Circuit A, and Circuit D exhibited a higher venous flow rate than Circuit C, at both temperatures. Flow resistance was significantly higher in Circuits A and C than in Circuits B (P<0.001) and D (P<0.001), respectively.

Conclusion:

A single 1/4" venous limb is better than dual 3/16" venous limbs at all flow rates, up to 1500 ml/min. Moreover, a single 3/8" venous limb is better than dual 1/4" venous limbs, up to 3000 ml/min. Our findings strongly suggest a revision of perfusion practice to include single venous limb circuits for CPB.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Oxygenators / Cardiopulmonary Bypass / Cannula Type of study: Evaluation studies / Prognostic study Limits: Humans Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2018 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Boston Children's Hospital/US / Emeritus Michigan State University/US / FEI University Center/BR / Penn State Health Children's Hospital/US / Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Oxygenators / Cardiopulmonary Bypass / Cannula Type of study: Evaluation studies / Prognostic study Limits: Humans Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2018 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Boston Children's Hospital/US / Emeritus Michigan State University/US / FEI University Center/BR / Penn State Health Children's Hospital/US / Universidade de São Paulo/BR