Zur Frage der Stofftransporteigenschaften von Oxygenatorhohlfasermembranen bezüglich der Durchlässigkeit für Fluide und Narkosegase

Microporous hollow fibre membrane oxygenators with clinically-established polypropylene (PP) or innovative polymethylpentene (PMP) membranes are used clinically for cardiopulmonary bypasses (CPB) and extracorporeal life support (ECLS). Membrane oxygenators with silicone plates may also be used. During long-term use of PP membrane oxygenators, plasma leakage is possible due to a variety of factors. The PMP membrane oxygenators developed to avoid this undesirable occurrence should be able to prevent this due to their modified, denser membrane structure. In the clinical use of PMP membrane oxygenators for CPB, the halogenated anaesthetic isoflurane cannot be administered in sufficient amounts. In the set-up to test steam transfer, the PP and PMP oxygenator modules were analysed for differences in permeability through perfusion with distilled water on the fluid side and streaming of dry gas on the gas side. No differences could be detected in the amount of water condensate, whose function as a trigger for plasma leakage is controversial. As with the silicone membrane oxygenators, the gas was fully saturated with water condensate. Should the condensation process in the microporous membrane be a trigger mechanism for plasma leakage, using a PMP membrane oxygenator would not offer a higher level of safety. However, the thin sealing membrane at the surface of PMP membrane oxygenators should theoretically provide greater resistance to capillary attraction. Leakage tests of the microporous hollow fibre membranes with Perfluorcarbon FC-43® and oxygenator test modules showed that PP membranes were able to prevent considerably less transfer. Admittedly, transfer was also detected with the PMP membranes. Silicone membranes appeared to retain FC-43® the best. Thus although PMP membranes could be considered to have better liquid retention properties than PP membranes, they are not 100% impervious. This observation means that plasma leakage seems far unlikelier when PMP membranes are used, although cannot be ruled out definitively. Thus in long-term clinical application for ECLS, PMP hollow fibre membrane oxygenators should be favoured over those with PP membranes. The narcotic gas transport capacity of hollow fibre membranes was explored in an in-vitro investigation. The oxygenator modules were perfused with saline solution and native porcine blood on the liquid side and aerated with the gaseous anaesthetics isoflurane, nitrous oxide and xenon on the gas side. The transport capacity of PP and PMP membranes showed no difference in the case of nitrous oxide and xenon, but the gas transfer performance of PP membranes was lower with isoflurane. Should a halogenated anaesthetic such as isoflurane be used during CPB and administered via a hollow fibre membrane oxygenator, use of PMP hollow fibre membrane oxygenators should be discouraged. This restriction does not apply to the administering of nitrous oxide or xenon. As purely in-vitro-experiments, the new test set-ups developed for the investigations could provide clinically-relevant knowledge. Further standardisation of the set-up could establish its use in future studies.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2009

Author dc:creator

• Hoffmann, Nicolas

Contributors dc:contributor

• Mottaghy, Khosrow

• info:eu-repo/classification/ddc/610
• Polypropylen
• Isofluran
• Xenon
• Distickstoffmonoxid
• Herz-Lungen-Maschine
• Medizin
• Plasma Leakage
• PP
• Polymethylpenten
• PMP
• HLM
• Extrakorporale Zirkulation
• EKZ
• Oxygenator
• Hohlfasermembran
• polymethylpentene
• cardiopulmonary bypass
• CPB
• extracorporeal circulation
• ECC
• hollow fibre membrane
• isoflurane
• nitrous oxide
• polypropylene

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113199%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50663