Original Articles

Plasma Free Hemoglobin Generation Using the EOS PMP^™ Oxygenator and the CentriMag^® Blood Pump

^* The Heart Center at Nationwide Children’s Hospital, Columbus, Ohio;
^† Department of Pediatrics, The Ohio State University, Columbus, Ohio;
^‡ Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio;
^§ Department of Pathology, Nationwide Children’s Hospital, Columbus, Ohio;
^¶ Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio;
^‖ Center for Cardiovascular Research, Nationwide Children’s Hospital, Columbus, Ohio; and
^# Section of Cardiology and Critical Care, Nationwide Children’s Hospital, Columbus, Ohio

Address correspondence to: Ashley B. Hodge, MBA, CCP, FPP, The Heart Center at Nationwide Children’s Hospital, 700 Children’s Drive, Room T2298, Columbus, OH 43205. E-mail: ashley.hodge@nationwidechildrens.org

Received: 14 September 2017
Accepted: 19 January 2018

Abstract

Hemolysis is a known consequence of extracorporeal membrane oxygenation (ECMO) resulting from shear force within the different components of the extracorporeal circuit. The primary aim of this study was to evaluate the EOS PMP^™ oxygenator for generation of plasma free hemoglobin (PfHg) over 24 hours at nominal operating range flow rates. The EOS ECMO^™ (LivaNova, Inc.; formerly Sorin, Arvada, CO) is equipped with a plasma tight polymethylpentene (PMP) hollow fiber oxygenator. We hypothesized that PfHg generation would be elevated in circuits with higher flow rates, because of the significant pressure drop across the oxygenator according to manufacturer provided flow charts. Generated PfHg concentrations were compared with PfHg concentrations from blood not exposed to an ECMO circuit. The secondary aim was to evaluate circuit flow-rate-induced changes in platelet count and platelet function over 24 hours. Circuits contained a CentriMag^® (St. Jude Medical, St. Paul, MN) blood pump and an EOS ECMO PMP^™ oxygenator. Circuits in triplicate were run continuously for 24 hours at three flow rates [1, 3, and 5 liters per minute {LPM}]. PfHg was analyzed at baseline, 6, 12, 18, and 24 hours. Platelet count and function were measured at baseline and 24 hours. Concentrations of PfHg at baseline for circuits operating at 1, 3, and 5 LPM were 24.4 ± 4.0, 38.4 ± 28.6, and 26.7 ± 6.9 mg/dL, respectively. PfHg concentrations after 24 hours were statistically compared for the three flow rates using analysis of variance; PfHg concentrations at 1 LPM (181.4 ± 29.1 mg/dL), 3 LPM (145.9 ± 8.7 mg/dL), and 5 LPM (100.1 ± 111.3 mg/dL) circuits. The F-test was not statistically significant (p = .632), indicating that PfHg generation at 24 hours was similar among the three flow rates. Excessive hemolysis using PfHg levels in the EOS PMP^™ membrane oxygenator was not observed.