The use of extracorporeal life support devices such as extracorporeal membrane oxygenation in adults requires cannulation of the patient's vessels with comparatively large diameter cannulae to allow circulation of large volumes of blood (>5 L/min). The cannula diameter and length are the major determinants for extracorporeal membrane oxygenation flow. Manufacturing companies present pressure-flow charts for the cannulae; however, these tests are performed with water. Aims of this study were 1. to investigate the specified pressure-flow charts obtained when using human blood as the circulating medium and 2. to support extracorporeal membrane oxygenation providers with pressure-flow data for correct choice of the cannula to reach an optimal flow with optimal hydrodynamic performance. Eighteen extracorporeal membrane oxygenation drainage cannulae, donated by the manufacturers (n = 6), were studied in a centrifugal pump driven mock loop. Pressure-flow properties and cannula features were described. The results showed that when blood with a hematocrit of 27% was used, the drainage pressure was consistently higher for a given flow (range 10%-350%) than when water was used (data from each respective manufacturer's product information). It is concluded that the information provided by manufacturers in line with regulatory guidelines does not correspond to clinical performance and therefore may not provide the best guidance for clinicians.

2nd Department of Medicine Department of Cardiovascular Medicine General University Hospital Prague and 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Advanced Heart Failure and Mechanical Circulatory Support Program Vita Salute University San Raffaele Hospital Milan Italy

Centro Hospitalar de Lisboa Central Hospital Curry Cabral Lisbon Portugal

Department of Cardio Thoracic Surgery Heart and Vascular Centre Cardiovascular Research Institute Maastricht Maastricht University Medical Hospital Maastricht The Netherlands

Department of Critical Care and Severe Respiratory Failure Service Guy's and St Thomas' NHS Foundation Trust London UK

Department of Intensive Care Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

Department of Internal Medicine 2 Cardiology and Pneumology University Medical Center Regensburg Regensburg Germany

Department of Medical Technology Karolinska University Hospital Stockholm Sweden

Department of Perfusion University Hospital Gasthuisberg Louven Belgium

Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden

Department of Physiology Maastricht University Maastricht The Netherlands

Department of Pulmonology Intensive Care Medicine Paracelsus Medical University Nuremberg Germany

ECMO Centre Karolinska Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital Stockholm Sweden

Pediatric Intensive Care Unit Children's Hospital Bambino Gesù IRCCS Rome Italy

The Linné Flow Centre and BioMEx Department of Mechanics KTH Royal Institute of Technology Stockholm Sweden

U O C Anestesia e Rianimazione 1 Fondazione IRCCS Policlinico San Matteo Pavia Italy

Working Group on Innovation and Technology EuroELSO Newcastle upon Tyne UK

Perfusion. 2020 Apr;35(3):271-272. doi: 10.1177/0267659119867182. PubMed

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