PVC Tubing in Cardiopulmonary Bypass

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Questions and Answers

Which material is the predominant tubing material used in cardiopulmonary bypass?

PVC (correct)

Silicone rubber

Nylon

Latex rubber

What type of bonds does PVC have?

Carbon-oxygen (C-O) bonds

Carbon-nitrogen (C-N) bonds

Carbon-chloride (C-Cl) bonds (correct)

Carbon-hydrogen (C-H) bonds

What property of PVC makes it a fairly strong material?

Considerable intermolecular attraction between polymer chains (correct)

High flexibility

Low density

High thermal conductivity

What are plasticizers added to PVC tubing for?

To improve its flexibility Signup and view all the answers

What do plasticizers do when added to a polymer?

Act as a lubricant Signup and view all the answers

Which organization has determined that nearly all plasticizers are safe?

The Registration for Evaluation, Authorisation, and Restriction of Chemicals (REACH) Signup and view all the answers

What would PVC be like without plasticizers?

Hard and rigid Signup and view all the answers

What is the purpose of the cartilage in your knee?

To cushion the joints and aid in movement Signup and view all the answers

What has the FDA determined about the safety of plasticizers?

They are all safe Signup and view all the answers

What has the REACH determined about the safety of plasticizers?

They are all safe Signup and view all the answers

Which material is the most popular for medical tubing?

PVC Signup and view all the answers

What are the two methods for the manufacture of plastic tubing?

Extrusion and Pultrusion Signup and view all the answers

What is the main ingredient in the extrusion process for plastic tubing?

Polymer resin Signup and view all the answers

What is the rating that defines the minimum or maximum pressures a tube is designed to withstand?

Pressure rating Signup and view all the answers

What is the rating based on the acceptable amount of deformation the tubing cross-section can undergo?

Minimum bend radius Signup and view all the answers

What is the name for the connectors used to make connections with tubing?

Fitting Signup and view all the answers

What is the method of connecting tubing where the tubing is heated and placed on the specified connection site?

Bonding Signup and view all the answers

Which sterilization method is best suited for polymer resin-based products and single-use medical devices?

Ethylene Oxide sterilization Signup and view all the answers

What are the four essential parameters that influence the effectiveness of Ethylene Oxide sterilization?

Gas concentration, temperature, humidity, exposure time Signup and view all the answers

How long does the basic Ethylene Oxide sterilization cycle take?

2 hours Signup and view all the answers

What is the term used to describe the degradation of the walls of tubing and the release of plastic micro particles?

Spallation Signup and view all the answers

What is the purpose of using a biocompatible coating on tubing?

To reduce the inflammatory response to foreign material Signup and view all the answers

What are the sequelae from the inflammatory response to foreign surfaces?

Platelet activation, initiation of the coagulation cascade, decreased levels of circulating coagulation factors, activation of endothelial cells and leukocytes Signup and view all the answers

What type of circuit coating uses both hydrophobic and hydrophilic properties to reduce protein denaturation and platelet adhesion?

Poly(2-methoxyethylacrylate) (PMEA) Signup and view all the answers

What is the most commonly used wall thickness in perfusion?

1/16’’ Signup and view all the answers

What factors should be considered when selecting the appropriate size of tubing?

Internal diameter and length Signup and view all the answers

What can a larger internal diameter of tubing result in?

Greater flow at lower pressures Signup and view all the answers

What can be used to track fluid movement and account for possible air bubbles in the system?

Clear tubing Signup and view all the answers

What is the ability to coil the tubing for storage or transport called?

Serializability Signup and view all the answers

Study Notes

Cardiopulmonary Bypass Tubing

The predominant tubing material used in cardiopulmonary bypass is PVC (Polyvinyl Chloride).
PVC has polar and non-polar bonds.

Properties of PVC

The property of PVC that makes it a fairly strong material is its high degree of crystallinity.
Plasticizers are added to PVC tubing to make it more flexible.
Plasticizers work by reducing the glass transition temperature of the polymer, allowing it to be more flexible.

Safety of Plasticizers

The FDA has determined that nearly all plasticizers are safe.
The REACH organization has also determined that plasticizers are safe.
Without plasticizers, PVC would be brittle and prone to cracking.

Manufacture of Plastic Tubing

The two methods for manufacturing plastic tubing are extrusion and injection molding.
The main ingredient in the extrusion process is polymer resin.
Tubing is rated based on its pressure resistance, with a rating that defines the minimum or maximum pressure a tube can withstand.
The rating is also based on the acceptable amount of deformation the tubing cross-section can undergo.

Tubing Connections

The connectors used to make connections with tubing are called fittings.
The method of connecting tubing by heating it and placing it on a specified connection site is called heat stake.

Sterilization

The sterilization method best suited for polymer resin-based products and single-use medical devices is Ethylene Oxide sterilization.
The four essential parameters that influence the effectiveness of Ethylene Oxide sterilization are temperature, humidity, gas concentration, and exposure time.
The basic Ethylene Oxide sterilization cycle takes 12 hours.

Tubing Degradation

The degradation of the walls of tubing and the release of plastic micro particles is called particulate generation.
Biocompatible coatings are used on tubing to reduce particulate generation and prevent inflammation.

Circuit Coatings

The sequelae from the inflammatory response to foreign surfaces are platelet activation, protein denaturation, and fibrin formation.
A circuit coating that uses both hydrophobic and hydrophilic properties to reduce protein denaturation and platelet adhesion is called a phosphorylcholine coating.

Tubing Selection

The most commonly used wall thickness in perfusion is 1/16 inch.
When selecting the appropriate size of tubing, factors such as internal diameter, wall thickness, and material should be considered.
A larger internal diameter of tubing can result in increased flow rates and decreased pressure drops.

Tubing Characteristics

Tubing can be used to track fluid movement and account for possible air bubbles in the system by using a level sensor or ultrasound.
The ability to coil the tubing for storage or transport is called flexibility.

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Description

Test your knowledge about the properties and uses of PVC tubing materials in cardiopulmonary bypass. Learn about the composition of PVC, its strength, and how it can be made more flexible.