G . S . Matte et al .: J Extra Corpor Technol 2024 , 56 , 216 – 224 223
Figure
4 . Our institution ’ s updated intervention algorithm for confirmed oxygenator issues during cardiopulmonary bypass .
Data
availability statement All data pertinent to this manuscript is included in the text .
Author contribution statement
GSM : manuscript preparation , analysis , pictures and final approval . WLR : Draft review and analysis . SIG : Draft review , analysis and pictures . KRC : Draft review and preparation . SLB : Manuscript preparation and analysis . FFT : Draft review and final approval .
Ethics approval
Ethics approval : An IRB waiver was granted for this manuscript ( IRB-P00049148 ).
Figure 5 . Picture of a Terumo CAPIOX FX-05 oxygenator with a neonatal / infant 3 / 16 ” arterial limb by 1 = 4 ” venous limb circuit , modified with venous limb Y to allow for maximal secondary oxygenator flow ( instead of standard venous line stopcock ). For instructional purposes , the image depicts a secondary oxygenator replacing the hemoconcentrator for venous-assisted oxygenation ( venous piggyback ). Secondary oxygenator flow returns to top of CVR .
We now consider the venous piggyback technique , sourcing blood from the venous limb of the circuit , a first-line intervention to afford enhanced patient safety while the clinical team decides on required interventions when oxygenator failure presents during CPB .
Funding No outside funding was used in the preparation of this manuscript .
Conflicts of interest
The authors declare no conflicts of interest with the content provided in this manuscript .
References
1 . Willcox T . Oxygenator failure – Are you prepared ? J Extra Corpor Technol . 2023 ; 55:153 – 154 .
2 . Da Broi U , Adami V , Falasca E , Malangone W , Crini S , Degrassi A . A new oxygenator changeout system and procedure . Perfusion . 2006 ; 21 ( 5 ): 297 – 303 .
3 . Soo A , Booth K , Parissis H . Successful management of membrane oxygenator failure during cardiopulmonary bypass – the importance of safety algorithm and simulation drills . J Extra Corpor Technol . 2012 ; 44 ( 2 ): 78 – 80 .
4 . Darling E , Searles B . Oxygenator changeout times : the value of a written protocol and simulation exercises . Perfusion . 2010 ; 25:141 – 143 . discussion 144 – 145 .
5 . Matte GS . Notes on select emergency procedures during bypass . In : Perfusion for congenital heart surgery : notes on cardiopulmonary bypass for a complex patient population . Oxford : Wiley-Blackwell ; 2015 ; 148 – 171 .
6 . Webb DP , Deegan RJ , Greelish JP , Byrne JG . Oxygenation failure during cardiopulmonary bypass prompts new safety algorithm and training initiative . J Extra Corpor Technol . 2007 ; 39 ( 3 ): 188 – 191 .
7 . Mongero LB , Beck JR . On bypass : advanced perfusion techniques . Totowa NJ : Humana Press ; 2008 : 404 – 406 .