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The European Board of Cardiovascular Perfusion


Please find below the survey and a brief synopsis if you would be so kind to share with all our perfusion colleagues

 

https://www.surveymonkey.co.uk/r/BS9MJ76

 

Please find attached a survey which we are kindly asking you to complete with regards to your departmental experience of oxygenator failure due to high pressure excursions. As a department we are noticing a recent increase in these phenomenon and would like to study this further to try and firstly understand them better and secondly to see if the covid 19 pandemic plays a role.  

 

HPE are the most commonly recorded adverse events involving membrane oxygenators. The phenomenon usually occurs upon initiation of CPB displaying as high pre membrane pressures, increasing trans membrane pressure drop and poor gas exchange. Common findings demonstrate a fibrin gel network with platelet activation which binds to the oxygenator fibres and heat exchanger. This significantly reduces the blood flow pathway leading to high membrane pressures and increases the distance for diffusive gas exchange leading to poor oxygenation.

 

There have been a number of common causes mentioned including patients with high platelet / fibrinogen levels, those who were previous smokers, and patients displaying heparin resistance. These incidents are most commonly occurring in patients undergoing CABG for coronary artery disease but most recently there seems to have been an increase due to the COVID 19 virus.  There hasn’t been any clear link between whether it is patients who may have been infected with the virus or an undocumented vaccine effect, but feel this is worth further study. 

  

Kindest regards

Emily


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