The International journal of artificial organs
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Randomized Controlled Trial Comparative Study
Clinical evaluation of five commercially available adult oxygenators in terms of pressure drop during normothermic and hypothermic cardiopulmonary bypass.
It is well documented that trans-membrane pressure drop (TMPD) of hollow-fiber membrane oxygenators (HFMO) may lead to hemolysis, damage to platelets, and systemic inflammatory response. The purpose of this study was to evaluate five commercially available adult oxygenators in terms of pressure drop during normothermic and hypothermic cardiopulmonary bypass (CPB). ⋯ These results suggest that the HFMOs in groups J and A produced significantly lower TMPDs and pre- and post-oxygenator extracorporeal circuit pressures during normothermic and hypothermic CPB.
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Adaptive support ventilation (ASV) is a microprocessor-controlled, closed-loop mode of mechanical ventilation that adapts respiratory rates and tidal volumes (V(T)s) based on the Otis least work of breathing formula. We studied calculated V(T)s in a computer simulation model, and V(T)s delivered in a test lung setting as well as in clinical practice. ⋯ The ASV performed as intended, bearing in mind that the ASV algorithm was originally designed to provide V(T)s between 8 and 12 ml/kg. However, the V(T)s that were calculated and delivered were frequently higher than those presently recommended in the guidelines. Considering the size of V(T) delivered in the setting of ALI using an open lung approach as well as in the setting of COPD, we feel caution should be taken when applying ASV in patients with these conditions.