Extracorporeal Life Support: Time Related Performance of a Fully Heparinized Circuit and Polymethilpentene Oxygenator

Purpose: Extracorporeal life support (ECLS) with polymethylpen- tene oxygenators and heparinized circuits is suggested to have extended durability with reduced risks of plasma leakage and throm- bosis. We herein report our experience with ECLS using a new generation system (PLS, Jostra-Maquet). Methods and Materials: Nineteen consecutive patients underwent ECLS with PLS for primary graft failure after heart or lung transplan- tation. Hourly arterial blood gas analysis and ECLS data were prospec- tively recorded during the assistance. Hourly differences in systemic perfusion/oxygenation and ECLS parameters were investigated with analysis of the variance. Results: Mean ECLS time was 10.0 days (3-22 days).One patient (5.2%) required oxygenator change after 10 days. ECLS flow (3.9 1.1 l/min), pump rounds (3499.0 712.4 rounds/min), FIO2 (72.9 20.2 %), and air flow (4.2 1.9 L/min)were stable throughout the entire assistance (p ns). From the 12th assistance day onward we noticed a slightly increasing trend in ECLS FIO2 and air flow (p ns).Patients’ arterial gas variables were stable throughout the entire ECLS with an average pO2 of 98.8 15.8 mmHg, pCO2 of 39.7 2.5 mmHg, PH of 7.4 0.3, and lactates of 4.5 5.5 mmol/L (p ns). Conclusions: Prolonged ECLS with polymethilpentene heparin coated systems is performed with negligible malfunction rate. Punctual arterial blood gases showed stable gas exchange/systemic perfusion even throughout prolonged assistance periods. Although a slight increase in ECLS air flow and FIO2 was required to maintain adequate gas exchanges after a certain assistance period, none of the ECLS variables changed significantly as a result of the steady performance of the PLS system.