• T H Pedersen, V Videm, J L Svennevig, H Karlsen, R W Ostbakk, O Jensen, and T E Mollnes.
• Surgical Department, National Hospital, University of Oslo, Norway.
• Ann. Thorac. Surg. 1997 May 1;63(5):1333-9.

BackgroundWe studied whether negative inlet pressure created by a centrifugal pump during extracorporeal membrane oxygenation damages blood.MethodsFresh, whole human blood and primer were circulated through a test circuit, applying an inlet pressure of 0, -50, or -100 mm Hg. Thereafter, hemolysis and kidney function were compared between 6 patients treated before and 14 patients treated after inclusion in our setup of extracorporeal membrane oxygenation with a servo inlet pressure regulator.ResultsIn vitro, negative inlet pressure caused substantial hemolysis, leukocyte and platelet destruction, and complement activation. Maximal plasma free hemoglobin concentrations were 199 mg/100 mL before use of the servo inlet pressure regulator and 40 mg/100 mL afterward (p = 0.06), and serum creatinine peaked at 330 and 115 mumol/L, respectively (p = 0.03). The minimal 24-hour diuresis normalized for weight was 4.8 mL/kg before use of the servo inlet pressure regulator and 45.6 mL/kg afterward (p = 0.03). Three of 5 evaluable patients before use of the servo inlet pressure regulator and 1 of 14 patients after inclusion in this setup experienced anuria (p = 0.04).ConclusionsThere were strong indications that reduction of negative pump inlet pressure with the servo regulator prevented hemolysis and kidney damage.

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