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Ann Thorac Surg 1997;64:1528
© 1997 The Society of Thoracic Surgeons

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Correspondence

Extracorporeal Membrane Oxygenation Using a Centrifugal Pump

Victorian Paediatric Cardiac Surgical Unit, Royal Children's Hospital, Flemington Rd, Melbourne, 3052, Australia.

To the Editor:

It was with much interest that we reviewed the recent article by Pedersen and associates [1]. However, there are some important points that we think need to be clarified. Their team used three inlet pressure conditions for this study: 0, -50, and -100 mm Hg. In our center, we have performed more than 100 extracorporeal membrane oxygenations in the last 10 years using the Biomedicus (Eden Prairie, MN) centrifugal pump exclusively (after initially trying roller pumps). In practice we never encounter such negative (ie, subatmospheric) inlet pressures. Typically, the monitored patient will show inlet pressures in the range of -20 to 0 mm Hg. Sometimes, the pressure becomes greater than 0, depending on the circulating blood volume. If the pressure becomes less than -20 mm Hg, the flow will decrease (causing an alarm to sound), requiring the patient's nurse to administer fluid. In an extreme case, a venous cannula may require repositioning. It is a mistake to think that only a constrained vortex (centrifugal) pump will produce a negative inlet pressure. This same study could have been undertaken with a roller pump, which can produce either positive or negative pressure, limited only by servo-regulation (if used) or circuit disruption. Servo-regulation of the Biomedicus pump appears to be a useful and effective way to monitor and control inlet pressure. As long as retrograde flow cannot occur when the pump head slows or stops, this is a great idea, and enhances the usefulness of the centrifugal pump in pediatric extracorporeal membrane oxygenation.

Reference

1. Pedersen TH, Videm V, Svennevig JL. Extracorporeal membrane oxygenation using a centrifugal pump and a servo regulator to prevent negative inlet pressure. Ann Thorac Surg 1997;63:1333–9.[Abstract/Free Full Text]

This article has been cited by other articles:

				V. Mishra, J. L. Svennevig, J. F. Bugge, S. Andresen, A. Mathisen, H. Karlsen, I. Khushi, and T. P. Hagen Cost of extracorporeal membrane oxygenation: evidence from the Rikshospitalet University Hospital, Oslo, Norway Eur. J. Cardiothorac. Surg., February 1, 2010; 37(2): 339 - 342. [Abstract] [Full Text] [PDF]

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Stephen Horton Tom R. Karl Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Horton, S. Articles by Karl, T. R. Search for Related Content PubMed PubMed Citation Articles by Horton, S. Articles by Karl, T. R.