The Use of a Hollow Fiber Membrane Oxygenator for Extended Extra-Corporeal Support

Abstract

There is a small percentage of patients, who having undergone cardiac surgery, are unable to be weaned from cardiopulmonary bypass. Some reports in the literature seem to indicate some success with extended extra-corporeal support. In an effort to reduce the amount of supplies needed and the resulting confusion of utilizing a completely different oxygenator, a hollow fiber membrane oxygenator was selected as the oxygenator of choice for an extended extra-corporeal support system. The hollow fiber membrane oxygenator for extended extra-corporeal support has been utilized on 5 patients in the past 12 months. Two patients were weaned from the system and all patients expired within 30 days. The hollow fiber membrane oxygenator performed adequately with respect to gas exchange and circulatory support. However, as extended extra-corporeal support approached 15 hours, there was evidence of plasma leakage across the membrane fibers. While there appeared to be no decrease in gas exchange, two hollow fiber membrane oxygenators were replaced because of the leakage. We conclude that the hollow fiber membrane oxygenator for extended extra-corporeal support may not be adequate for support periods above 12 to 15 hours.