An Under-Occluded Roller Pump is Less Hemolytic Than a Centrifugal Pump

Abstract

The purpose of this study is to measure and compare the hemolysis produced by roller pumps with varied occlusion settings and a centrifugal pump. The null hypothesis is that there is no difference in the Index of Hemolysis (IH=gm Hb/100 L pumped) produced by a roller pump (RP) at four different occlusion settings and a centrifugal pump (CP) at the same blood flow rate (4.5 L/min) and afterload (250 mmHg, ±10 mmHg) over three hours. Five identical closed-loop circuits were assembled and primed with saline. The pumps were then calibrated and occlusions were set. In three circuits, the occlusion for the RP was opened at 5 RPMs to support 150, 225, or 300 mmHg (±10 mmHg) against a clamped line. In one circuit, a RP was adjusted to a barely non-occlusive setting (1 cm drop/30 inch gradient). The fifth circuit employed a CP. Prior to testing, the saline in each circuit was replaced with one liter of fresh bovine blood (Hct=22±2%). The IH for each treatment was compared in six trials yielding a statistical power> 0.80. Analysis of variance with multiple comparison (p≤0.05) demonstrated that compared to the barely non-occlusive setting, the IH in the centrifugal pump was not significantly greater. Under-occluded RP settings yielded IHs significantly less than the CP. It appears that opening the occlusion on a roller pump allows a lower IH compared to traditional RP occlusion setting or centrifugal pumping.