DIFFERENT TYPE OF ECMO NEW OXYGENATOR.pptx

OXYGENATOR

1. 矽膠膜型膜肺 silicone membrane 中空纖維型膜肺 hollow fiber polypropylene 聚丙烯 polymethylpentene 聚甲戊烯 血漿滲漏 少 多 對血液成分破壞程度 小 大 時間 適合長時間輔助 適合短時間輔助 安裝 略難 相對簡單 排氣 困難 簡單 價格 昂貴 相對便宜 用於 支援心肺功能，等待移植，或感染所致呼吸功能衰竭 急救首選

2. Hollow fiber PMP oxygenators for ECMO.

3. The Characteristics of ECMO Oxygenators Oxygenator Medos Hilite 800 LT/2400 LT Maquet Quadrox-iD Pediatric Sorin Lilliput 2/EOS ECMO Eurosets ECMO New Born/Pediatric Chalice Paragon PMP Neonatal/Infant/Pediatric Priming volume (mL) 55/95 81 90/150 90/190 65/145/175 Gas exchange surface area (m 2 ) 0.32/0.65 0.8 0.67/1.2 0.69/1.35 0.45/0.88/1.23 Maximal flow rate (L/min) 0.8/2.4 2.8 2.3/5.0 1.5/4.0 1.4/3.0/4.0 Hollow fiber material Polymethylpentene Polymethylpentene Polymethylpentene Polymethylpentene Polymethylpentene Coating material Rheoparin Bioline Phosphorylcholine Phosphorylcholine Rhe

4. Affinity Fusion

5. Affinity NT Oxygenation System

6. Nautilus ECMO oxygenator specations

7. Oxygenators provide gas exchange and may be composed of silicone membrane or hollow fiber. Silicone membrane oxygenators (Fig. 22-11) have been the standard for many years. They have excellent biocompatibility and good gas-exchange characteristics, and they are relatively nonthrombogenic . However, they have a high resistance to blood flow, are difficult and time-consuming to prime, and cannot be coated with heparin. They are less efficient than hollow-fiber devices, and sometimes two oxygenators, placed in parallel, are required. In comparison, hollow-fiber oxygenators have more efficient gas exchange, are quick and easy to prime, and can be coated with heparin. The original polypropylene hollow-fiber oxygenators (e.g., Maxima [Medtronic Bio Medicus , Eden Prairie, ME]) develop a plasma leak through the membrane, usually after 1 to 5 days, which requires replacement of the oxygenator and makes them unsuitable for anything other than emergency or short-term ECMO. There is now a new generation of polymethylpentene hollow-fiber oxygenators, such as Jostra Quadrox ( Maquet Cardiopulmonary, Rastatt , Germany [Fig. 22-12]) and Medos Hilite 7000LT ( Medizintechnik , Stolberg, Germany), which do not develop a plasma leak, have lower platelet consumption, and require less blood product support.84 Currently, these polymethylpentene hollow-fiber oxygenators are not licensed by the FDA.

8. Type of extracorporeal membrane oxygenator used by region.

9. Hollow fiber microporous membrane oxygenator. The oxygenator contains multiple bundles of hollow fibers. "Ventilating" gas (oxygen, air, volatile anesthetic agents, carbon dioxide) is passed through the inside of the hollow fibers, while the venous return blood is passed around the hollow fibers to accomplish gas exchange by diffusion. Turbulence of the blood as it passes around the fibers assures effective gas exchange with all of the blood.

10. AMG PMP Oxygenator benefits and features : PMP fibers – for reliable gas exchange performance over duration of use PC Coating – to minimize inflammation1 and thrombosis2 Stainless steel heat exchanger – can eliminate risk of any potential contamination Low shear stress – based on shape, fiber orientation, and blood flow path

11. Blood path fully coated with phosphorylcholine (PC) coating PC creates a permanent water barrier between blood and the oxygenator surface that minimizes thrombus formation and promotes resistance to bacterial adhesion.3