Pump-induced haemolysis: is the constrained vortex pump better or worse than the roller pump?

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Abstract
Over 95% of paediatric Extra Corporeal Membrane Oxygenation (ECMO) centres use a roller pump (RP) rather than a constrained vortex pump (CVP); this is in part because of the concern of excessive haemolysis from the CVP. We have used a CVP in 36 children who received ECMO and 18 children who received cardiac support alone. We have compared our incidence of haemolysis with that recorded in the ECMO registry of the ExtraCorporeal Life Support Organization (ELSO); seven out of our 54 patients and 367 out of 4598 ELSO patients had haemolysis (p = 0.28). We also did a paired laboratory evaluation of both the RP and CVP comparing the haemolysis caused by each pump over five continuous days. The roller pump was more haemolytic than the constrained vortex pump (CVP range day 1, mean 6.8mg/dL to day 5, mean 31.3mg/dL; RP range day 1, mean 13.5mg/dL to day 5, mean 232.3mg/dL).

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