Is Your Oxygenator Failing? Diagnosis and Suggested Treatment

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Abstract
(J. Extra-Corpor. Technol. 19[3] p. 330-337 Fall 1987, 3 ref.) Oxygenator failure during open heart surgery can be a serious complication but one with which perfusionists should be prepared to deal. We hypothesize that oxygenators are often replaced unnecessarily and when they are performing within the manufacturers' specifications. This suspicion was confirmed by surveying several oxygenator manufacturers. Discriminating between oxygenator and nonoxygenator problems is critical. In the face of the correct diagnosis of oxygenator failure a simple, safe, expedient, and familiar method of replacement is needed.By using the gas transfer equations one can determine if the oxygenator is transfering adequate gas, after other associated problems are considered and ruled out.After oxygenator failure has been diagnosed, a plan for replacement which has previously been established and practiced should be implemented. We studied 2 techniques for hollow fiber membrane oxygenation (HFMO) replacement and found the risk of micro-air, as a result of the changeout procedure, decreased when the new oxygenator was vacuumed.The purpose of this paper is to help identify when/if an oxygenator is failing and suggest a planned replacement drill to help minimize confusion, delay and possible complications. We will also present a technique for decreasing the risk of micro-air which may result from a quick oxygenator changeout.

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