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Blood flow rate. Oxygen consumption rates (oxygen delivery/oxygen demand). Peripheral vascular resistance (perfusion pressure). Renal function. Coagulatory status. ACKNOWLEDGEMENTS This chapter is based on Chapter 3 in the third edition of Techniques in Extracorporeal Circulation and was originally written by L. Bigi, N. Ghelli, A. Menghini and I. Panzani of Dideco SpA, Italy. Medtronic, AFFINITY, autoLog, Bio-Pump, MYOtherm and Trillium are trademarks of Medtronic, Inc. Carmeda is a registered trademark of Carmeda AB, Sweden.

Perhaps surprisingly, non-occlusive pumps are associated with high rates of haemolysis as well as fully occlusive ones. This is due to turbulence, back-flow, and the build-up of kinetic energy within the tubing, as well as the need for faster revolutions, since less volume is displaced in each cycle. The best form of occlusion has been shown to be ‘just nonocclusive’, exhibiting the lowest rates of haemolysis. Blood cell trauma has been associated with increased speed and increased number of rollers, mainly because of their effects on shear stress, kinetic energy, friction heat and direct compressive action.

Protein adsorption results in platelet adhesion and the activation of coagulation pathways, leading to thrombus formation (Lee and Oh, 2002). PEO creates an ‘insulating’ hydrated layer at the interface between the blood and artificial surface. 15 Trillium™ Biosurface. Schematic © copyright Medtronic, Inc. , 1995, 2000). , 1995), due to their flexible molecular structure. , 1995, 2000). , 1999). , 1999). Heparin coatings for cardiopulmonary bypass have the most extensive published scientific and clinical data supporting their benefits.

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