2021 SCPS AGM
SPEAKER ABSTRACTS
05-07 NOVEMBER 2021

High Pressure Excursions – Stressful trip abroad or a potentially fatal oxygenator emergency?

Emily woods
DAY 1 SPEAKER
GUEST

Objectives

To look at literature and explore our own experiences surrounding high pressure excursions, to highlight causes and high risk patients and determine a strategy for management and prevention. Finally to consider a link between reported increase in HPEs and the Covid 19 pandemic

Methods

Literature review Case study review Multi centre survey

Results / Discussions

HPE are the most commonly recorded adverse events involving membrane oxygenators. The phenomenon usually occurs upon initiation of CPB displaying as high pre membrane pressures, increasing trans membrane pressure drop and poor gas exchange. Common findings demonstrate a fibrin gel network with platelet activation which binds to the oxygenator fibres and heat exchanger. This significantly reduces the blood flow pathway leading to high membrane pressures and increases the distance for diffusive gas exchange leading to poor oxygenation.

There have been a number of documented common causes including patients with high platelet / fibrinogen levels, those who were previous smokers, and patients displaying heparin resistance. These incidents are most commonly occurring in patients undergoing CABG for coronary artery disease but most recently there seems to have been an increase potentially due to the COVID 19 virus.

Conclusions

Making practitioners aware of these highly stressful occurrences can only benefit clinical practice. Following a clear protocol to try and alleviate the HPE can reduce the number of potentially unnecessary oxygenator change outs and ultimately reduce patient risk.

PRE-RECORDED VIDEO OF 2021 AGM PRESENTATION AVAILABLE?
YES
Videos that have been pre-recorded will be available in our member's area on the website by 12/11/2021. Additional submissions will be added where possible.

SPEAKER PROFILE

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