Optimization of venous return tubing diameter for cardiopulmonary bypass

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Serval ID
serval:BIB_1752EB4F2094
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Optimization of venous return tubing diameter for cardiopulmonary bypass
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Ni  Y. M., Leskosek  B., Shi  L. P., Chen  Y. L., Qian  L. F., Li  R. Y., Tu  Z. L., von Segesser  L. K.
ISSN
1010-7940
Publication state
Published
Issued date
09/2001
Peer-reviewed
Oui
Volume
20
Number
3
Pages
614-20
Notes
Clinical Trial
Journal Article --- Old month value: Sep
Abstract
OBJECTIVE: To determine the optimal venous tubing diameter for adult cardiopulmonary bypass (CPB) to improve gravity drainage and to reduce priming volume. METHODS: (A) Maximum bovine blood flow rates by gravity drainage were assessed in vitro for four different tubing diameters (1/2, 3/8, 5/16,1/4 inch) with three different lengths and various pre- and afterloads. Based on the results of (A) and multiple regression analyses, we developed equations to predict tubing sizes as a function of target flows. (C) The equations obtained in (B) were validated by ex vivo bovine experiments. (D) The clinically required maximal flows were determined retrospectively by reviewing 119 perfusion records at Zurich University. (E) Based on our model (B), the clinical patient and hardware requirements, the optimal venous tubing diameter was calculated. (F) The optimized venous tubing was evaluated in a prospective clinical trial involving 312 patients in Hangzhou. RESULTS: For a mean body surface area of 1.83+/-0.2 m(2), the maximal perfusion flow rate (D) achieved with 1/2-inch (=1.27 cm(2)) venous tubing was 4.62+/-0.57 l/min (range: 2.50-6.24 l/min). Our validated model (B,C) predicted 1.0 cm(2) as optimal cross-sectional area for the venous line. New tubing packs developed accordingly were used routinely thereafter. The maximal flow rate was 4.93+/-0.58 l/min (range: 3.9-7.0) in patients with a mean body surface area of 1.62+/-0.21 m(2). CONCLUSION: The new venous tubing with 1.0-cm(2) cross-sectional area improves the drainage in the vast majority of adult patients undergoing CPB and reduces the priming volume (-27 ml/m). Reduced hemodilution can prevent homologous transfusions if a predefined transfusion trigger level is not reached.
Keywords
Adult Animals Blood Flow Velocity Cardiopulmonary Bypass/*instrumentation Cattle Equipment Design Female Hemorheology Humans Intubation/instrumentation Male Prospective Studies
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2008 14:17
Last modification date
25/09/2019 6:08
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