Rupture of extra-corporeal circuit tubing during cardiopulmonary bypass

• Published in: The Journal of extra-corporeal technology 2008-03, Vol.40 (1), p.74-76
• Main Authors: Sai Krishna, Cheemalapati, Naresh Kumar, Palli Venkata, Satpathy, Soumya Kanta, Ram Mohan, Kanteti, Ramesh Babu, Vedangi
• Format: Article
• Language: English
• Subjects: Abstract; Cardiopulmonary Bypass - adverse effects; Child, Preschool; Equipment Design; Equipment Failure; Extracorporeal Circulation; Extracorporeal Membrane Oxygenation - adverse effects; Extracorporeal Membrane Oxygenation - instrumentation; Health technology assessment; Heart Arrest - etiology; Heart Septal Defects, Ventricular - surgery; Humans; Male; Perfusion; Polyvinyl Chloride
• ISSN: 0022-1058; 2969-8960
• DOI: 10.1051/ject/200840074

Roller pumps are widely used for cardiopulmonary bypass in developing nations by virtue of proven safety during several years of institutional use and cost effectiveness. However, careful adjustment of roller occlusion is needed because they are known to cause spallation, tubing wear, and the occasional incident of rupture of tubing in the extracorporeal circuit. Rupture of polyvinylchloride tubing in the pump raceway during repair of a ventricular septal defect in a 4-year-old child is discussed. The event was managed by exclusion and replacement of the defective tubing during a short period of arrest. Use of an inappropriate boot pump and failure to detect its inclusion in the bypass circuit was a significant departure from protocol. However, because occlusion settings and duration of perfusion were within acceptable limits, a manufacturing flaw could also have contributed to tubing failure, and the event may or may not have been averted by the use of larger tubing. In conclusion, this incident reiterates the need for adherence to established protocol during assembly of the pump and draws attention to the fact that tubing integrity is not a guarantee and vigilance is warranted to handle its failure.