Issue |
J Extra Corpor Technol
Volume 21, 1989
Proceedings of AmSECT’s 27th International Conference
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Page(s) | 19 - 23 | |
DOI | https://doi.org/10.1051/ject/198921S019 | |
Published online | 24 August 2023 |
Original Article
Hollow Fiber Membrane Oxygenator Reduces Platelet Loss During Simulated Extracorporeal Circulation
University of Pennsylvania School of Medicine, Department of Surgery, Division of Cardiothoracic Surgery, Philadelphia, PA and PSI COR, Inc., San Diego, CA
* Address correspondence to: V. Paul Addonizio, MD, Temple University School of Medicine, Department of Surgery, Broad and Ontario Streets, Philadelphia, PA 19140
Contact between blood and the extracorporeal circuit results in adverse alterations in platelet number and function. To determine the effects of surface composition and flow on these changes, 450 ml of heparinized (5 U/ml) blood from random, aspirin-free volunteers was recirculated at a flow rate of twice the circulating volume for 2 hrs at 37°C through circuits with an identical surface area (1.0m2). These circuits contained either a spiral coil, silicon rubber, membrane oxygenator (SC) or a hollow fiber, polypropylene membrane oxygenator (HF). In SC circuits (n=5), platelet counts fell to 10±3% (±SEM p <.05) at 5 min. rising to 60±9% (p < .05) at 2 hrs. of extracorporeal circulation (ECC). In contrast, in HF circuits (n=5), the platelet count fell to only 53±7% (p < .05) at 5 min of ECC and rose to 82 + 14% (p > .05) at 2 hrs. Plasma levels of the platelet-specific protein platelet factor (PF) 4 rose to 2780 ± 222 ng/ml (p <.05) by 5 minutes, reaching 6338 ±.767 ng/ml (p < .05) at 2 hours in SC circuits. In contrast, PF4 in HF circuits rose to 836±73 ng/ml and 2640 ± 410 ng/ml (p < .05), respectively. Although platelets in the SC circuits became insensitive to ADP ≥ 50 uM) within 5 min, platelets from HF circuits aggregated to ADP (17 uM) despite 2 hrs of ECC. We conclude that the hollow fiber membrane oxygenator not only reduces adhesion, maintaining the circulating platelet count, but also reduces platelet protein release and preserves platelet function as well.
Key words: Platelet function / membrane oxygenator / spiral coil vs. hollow fiber
© 1989 AMSECT
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