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What’s an Oxygenator?

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An oxygenator is a vital component of the heart-lung machine system used during cardiopulmonary bypass surgery. It takes over the lungs’ workload, removing impurities and adding oxygen to the blood. The machine can also act as a life support system, and is used in NICUs. Perfusionists operate the oxygenator and are critical to successful surgery. The heart-lung machine was first used on a human in 1953 and has been partly responsible for saving many lives.

An oxygenator, also called a membrane oxygenator, is a crucial part of the heart-lung machine system. Its function is to take over the workload of the lungs during cardiopulmonary bypass (CPB) surgery. The device is operated by a perfusionist and is used to remove carbon dioxide and add oxygen to the blood while the patient is under anesthesia. After the impurities in the blood have been extracted, the clean, or red, blood is pumped back into the patient. Another device called a heparin-coated oxygenator can also be used during CPB and is thought to reduce inflammation and the potential for blood clots within the system.

The machine essentially takes over the function of the lungs, but can also act as a more sustained life support system by continuing to oxygenate the blood after surgery. This is called extracorporeal membrane oxygenation. The oxygenation system is often employed by NICU staff to care for critically ill newborns. Inside the machine is a very thin absorbent membrane that separates the blood and gas and allows impurities, such as carbon monoxide, to seep into the gas for disposal. The oxygenating component can be used for several days and is then discarded.

The heart-lung machine, of which the oxygenator is a component, is essentially a device that continues the flow of blood and oxygen during an operation in which heart function has been artificially disrupted. Potassium citrate is pumped through the coronary system to stop the heart from contracting. This allows the doctor to perform surgery while the organ is deprived of blood and oxygen. There are some cases where surgeons are able to perform open heart surgery when the heart is still beating.

Perfusionists, sometimes known as the ‘pump team’, operate the oxygenator and are critical to successful CPB. These specialists are also tasked with monitoring blood cell counts and circulation during surgery. An anesthesiologist can direct the perfusionist to administer drugs through the oxygenation system during certain critical phases of the operation. The perfusionist is a vital part of the cardiac surgery team and experienced technicians are in high demand.

The heart-lung machine was first used on a human in 1953 and had only two permanent components; the oxygenator and the pump. Due to cost, disposable parts were introduced in the late 1950s. Heart lung machines are used during all cardiopulmonary bypass surgeries and have been partly responsible for saving many lives.

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