Pediatric Hospital Uses New Technology to Remove Gaseous Microemboli and Reduce Blood Usage

Nationwide Children’s Hospital in Columbus, Ohio, recently conducted an air handling evaluation of the CAPIOX® FX05 Oxygenator, a next-generation pediatric oxygenator with integrated arterial filter. It was the first hospital in the U.S. to use the CAPIOX FX oxygenator. A corresponding study by its perfusionists is being published in the journal, Perfusion.

Nationwide Children's Hospital Study Results

The Nationwide Children’s study evaluated the performance and air handling of six CAPIOX FX05 Oxygenators with integrated arterial line filters, versus 13 CAPIOX® Baby RX05™ Oxygenators from October through December 2008. The Luna EDAC™ Quantifier was used to quantify gaseous microemboli (GME) during the evaluation.

• When comparing the volume and number of GME entering and exiting the oxygenator, there was a significant reduction in the GME exiting in both groups.
  • Regarding volume, the CAPIOX FX05 oxygenator was statistically significant at p = 0.02 and the CAPIOX Baby RX oxygenator was statistically significant at p = 0.01.
  • Regarding the number of GME, the CAPIOX FX05 oxygenator volume decrease was statistically significant at p = 0.04 and the CAPIOX Baby RX oxygenator was statistically significant at p = 0.01.
• The FX05 oxygenator primes as quickly and as easily as the CAPIOX RX05 oxygenator, but has the additional benefit of the 32 micron integral arterial filter.
• Significant prime volume reduction is possible, without sacrificing safety, for institutions utilizing a circuit with a separate oxygenator and arterial line filter (ALF).

“We were initially interested in the FX oxygenator because our center doesn’t use arterial line filters with our smallest patients,” says Dan Gomez, CCP, staff perfusionist at Nationwide Children’s Hospital. The CAPIOX FX oxygenators are the world’s first oxygenators with a truly integrated arterial filter.

“We’re more aligned with the European practice with regard to using an arterial filter,” states Mr. Gomez.

Despite the popularity of the ALF in North America, it is not used on patients weighing less than 15 kg at Nationwide Children’s Hospital. Ninety-eight percent of North American centers use an ALF in the CPB circuit according to the pediatric survey conducted by Robert Groom, CCP.¹ In Europe, the ALF is not an integral part of the pediatric circuit.

Lower prime volume and lower blood usage

The study also determined the CAPIOX FX05 oxygenator primes as easily and performs as well as the CAPIOX RX05 oxygenator. The researchers wrote that integrating the arterial line filter into the oxygenator may lead to:

• significant reduction in prime volume
• decreased exposure to foreign surfaces with subsequent reduction in inflammation
• potential elimination or reduction in blood product exposures

“I was impressed with its air handling,” says Mr. Gomez. “The FX oxygenator did everything the RX oxygenator did with the added safety of an arterial filter.”

Using the integrated filter and lowering prime volume has the potential to lower blood usage. Mr. Gomez said the CAPIOX FX05 oxygenator could save 60 ml of prime with a small patient and 150 ml of prime with a large patient. “We’re trying to produce a bloodless surgery for our patients. The FX oxygenator helps us with this goal while providing the safety of an arterial line filter,” states Mr. Gomez.

“We have intentionally designed our circuits to contain the smallest prime volume possible,” Mr. Gomez wrote in the study. “The FX05 fulfills our needs as both an oxygenator and arterial filter, while maintaining our miniature circuit prime volumes.”

1 Groom, RC, et al. Update on pediatric perfusion practice in North America: 2005 survey. J Extra Corpor Technol. 2005 Dec;37(4):343-50.