Differential diagnosis of suboptimal oxygenator performance

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Abstract
During cardiopulmonary bypass (CPB), the perfusionist must be able to differentiate between: (1) a normal oxygenator with oxygen transfer reserve; (2) a normal oxygenator without O2 transfer reserve; and (3) a failing or suboptimal oxygenator. The purpose of this paper is to report on the use of the oxygen transfer slope, as well as other evaluation techniques previously described, which aided in the differential diagnosis of suboptimal oxygenator performance. We were able to determine the presence and extent of the dysfunction, follow the progression over time, and assess the effectiveness of our intervention. As a direct result of our ability to carefully monitor the oxygenator, replacement was not necessary despite severe dysfunction.