A clinical report of the use of low-molecular-weight dextran in a rotating oxygenator.

Increasing use of heart-lung machines accentuates the desirability of reducing demands on blood donors by the addition of other priming fluids. Neptune, Bougas, and Panico (1960) described a machine requiring no priming blood, and Zuhdi, McCollough, Carey, Krieger, and Greer (1961) accepted haemodilution by 5% dextrose solution during hypothermic perfusion. Recently Long, Sanchez, Varco, and Lillehei (1961) have used low molecular weight dextran during perfusion, and demonstrate by elegant studies of the microcirculation that reduction in " sludging" of red cells results in improved peripheral circulation. Drake and Lewis (1961) are unable to confirm this effect but note the prevention of haemoconcentration during hypothermia as a benefit. Finsterbusch, Long, Sellers, Amplatz, and Lillehei (1961) found improved renal flow during perfusion using low molecular weight dextran. All these studies used low flow perfusion rates. Unusual foaming characteristics when using dextrans in bubble oxygenators may be acceptable because of the debubbling methods already necessary but might provide special difficulties in the use of a rotating oxygenator, particularly at high flow rates. A clinical trial of these features has been successfully carried out.