Impact of Oxygenator Selection on Hemodynamic Energy Indicators Under Pulsatile and Nonpulsatile Flow in a Neonatal Extracorporeal Life Support Model

Abstract

This study compared the quality of perfusion delivered by two oxygenators--the hollow-fiber membrane Capiox Baby RX05 and silicone membrane Medtronic 0800--using hemodynamic energy indicators. The oxygenators were tested across varying flow rates and perfusion modes in a neonatal extracorporeal life support (ECLS) model. The experimental ECLS circuit included a Jostra HL-20 heart/lung machine with Jostra Roller pump, oxygenators with associated tubing and components, and a neonatal pseudo-patient. We used a 40/60 glycerin/water solution in the circuit as a blood analog. Testing occurred at flow rates of 250, 500, and 750 mL/min at 37°C under both pulsatile and nonpulsatile flow conditions. Hemodynamic data points consisted of recording 20-s intervals of data, and a total of 96 experimental repetitions were conducted. The pressure drop across the Capiox Baby RX05 oxygenator was significantly lower than the pressure drop across the Medtronic 0800 at all flow rates and perfusion modes. Furthermore, the Medtronic 0800 oxygenator showed significantly lower post-oxygenator energy equivalent pressures, total hemodynamic energy values, and surplus hemodynamic energy retention values compared to those of the Capiox Baby RX05. These results indicate the Medtronic 0800 oxygenator significantly dampens the hemodynamic energy compared to the Capiox Baby RX05. Consequently, clinical use of the Medtronic 0800 in a pulsatile ECLS setting is likely to mitigate the benefits provided by pulsatile flow. In contrast, the Capiox Baby RX05 better transmits hemodynamic energy to the patient with much lower pressure drop.