Laboratory Evaluation of XXXX and Systemic Inflammatory Response in Neonatal Nonpulsatile and Pulsatile Extracorporeal Life Support Systems.

@entity1 @entity650 @entity39 @entity5 @entity880 @entity72087 @entity2142 @entity687
UNASSIGNED: The objective of this study was to compare the systemic inflammatory response and hemolytic characteristics of a conventional roller pump ( @entity72087 -NP) and an alternative diagonal pump with nonpulsatile (DP3-NP) and pulsatile mode (DP3-P) in simulated neonatal extracorporeal life support (ECLS) systems. The experimental neonatal ECLS circuits consist of a conventional Jostra @entity72087 roller pump or an alternative Medos DP3 diagonal pump, and Medos Hilite 800 LT hollow-fiber oxygenator with diffusion membrane. Eighteen sterile circuits were primed with freshly donated whole blood and divided into three groups: conventional @entity72087 with nonpulsatile flow ( @entity72087 -NP), DP3 with nonpulsatile flow (DP3-NP), and DP3 with pulsatile flow (DP3-P). All trials were conducted for durations of 12   h at a flow rate of 500   mL/min at 36  C. Simultaneous blood flow and pressure waveforms were recorded. Blood samples were collected to measure plasma-free hemoglobin (PFH), @entity1 @entity5 @entity39 factor-alpha, @entity650 ( @entity650 ), and @entity687 , in addition to the routine blood gas, @entity880 dehydrogenase, and lactic acid levels. @entity72087 -NP group had the highest PFH levels (mean        standard error of the mean) after a 12-h ECLS run, but the difference among groups did not reach statistical significance ( @entity72087 -NP group: 907.6        253.1   mg/L, DP3-NP group: 343.7        163.2   mg/L, and DP3-P group: 407.6        156.6   mg/L, P   =   0.06). Although there were similar trends but no statistical differences for the levels of proinflammatory cytokines among the three groups, the @entity72087 -NP group had much greater levels than the other groups (P   >   0.05). Pulsatile flow generated higher total hemodynamic energy and surplus hemodynamic energy levels at pre-oxygenator and pre-clamp sites (P   <   0.01). Our study demonstrated that the alternative diagonal pump ECLS circuits appeared to have less systemic inflammatory response and @entity2142 compared with the conventional roller pump ECLS circuit in simulated neonatal ECLS systems. Pulsatile flow delivered more hemodynamic energy to the pseudo- @entity1 without increased odds of @entity2142 compared with the conventional, nonpulsatile roller pump group.
