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Plasma leakage through microporous membranes. Role of phospholipids.
Resently confronted with the problem of plasma leakage out of the gas exhaust port of the oxygenator, necessesatatting changing of the oxygenator several times in 48 hours. We noted that the the plasma in the discarded oxygenator that had seperated was milky white in color and we checked for hyperlipidemia which was affirmed. In addition, propofol was being used and the patient had elevated glucose levels. An insulin drip was started and the propofol replaced with versed. The subsequent oxygenator survived 6 hours and hte next over 24 hours indicating improvment. Measured lipid levels wer also lower.
Believeing that the root couse was the hyperlipidemia but not having confirmation of this, I contacted an engineering friend that works with these types of hollow fibers. He subsequently forwarded me this article.
The investigators, under experimental conditions, created plasma leakage in the hollowfiber oxygenators and conclude that the absorbtion of phospholipids leads to the formation of a hydrophilic layer over the surface of the membrane which is hydrophobic leading to plasma leakage.