Proceedings

Ventilation Technique for CPB Patients Less Than 10 Kilograms Employing a 1.6 m² Hollow Fiber Membrane

Extracorporeal Technologies, Inc., Indianapolis, IN

^* Direct communications to: George A. Justison, 3380 Founders Road, Indianapolis, IN 46268.

Abstract

The purpose of this study was to document the performance of a 1.6 m² hollow fiber membrane blood oxygenator (HFMO) in a specific ventilation technique for a patient population averaging 6 kilograms and .34m² BSA.

Continuous monitoring was utilized to maintain actual Pa02 about 200 mmHg and Pv02 above 35 mmHg. HFMO expired gas pC02 was monitored to select the optimal 0 2/room air sweep rate to maintain actual PaC02 between 35 and 40 mmHg. Cardiopulmonary bypass (CPB) blood flow was initiated at 160 ml/min/kg and decreased to 100 ml/min/kg at 20°C. During warming, blood flow was increased to 175 ml/min/kg at 38°C. The hematocrit averaged 18% during cooling, low blood flow and/or exsanguination. Transfusion raised the average hematocrit to 29% at 38°C. HFMO average control parameters were:

The Terumo HFMO integral heat exchanger cooled these patients at an average rate of .16°C/min/kg, warming with a safe gradient yielded an average rate of .09°C/min/kg.

The 1.6 m² HFMO provides more than adequate heat, oxygen and carbon dioxide transfer for this patient population.