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Figure 4. s5 MES circuit design. DLP: Drainage line pressure, Filter: CPB hemofilter for conventional and modified ultrafiltration, CVVH: Continuous Veno-Venous Hemofiltration. Figure 5. s5 MES circuit technique.
ischemia-reperfusion injury, operative trauma, and blood contact with artificial surfaces [ 6 ]. The benefit of modifying the in situ ECMO circuit for cardiac surgery, rather than converting to a new CPB circuit, reduces the total surface area and priming volume, thereby minimizing patient hemodilution( Table 1).
Rat models have shown that higher priming volumes lead to significantly elevated levels of pro-inflammatory cytokines TNF-a and IL-6 [ 7 ]. Also, by reducing the foreign surface area, the expression of the leukocyte-specific receptor CD11b, as a marker of inflammatory response, is reduced [ 3 ]. Thus,