Arterial and Venous Air Emboli in Health Care

Myers, Gerard J.

doi:10.1051/ject/202153220

Cited by 4 publications

(5 citation statements)

References 42 publications

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“…The patients who underwent ECC with the Horizon VR and oxygenator A.L.ONE AF PLUS with unexpected predisposing factors for micro-embolic activity, did not show any statistically significant difference in terms of (µL) the GME volume in the arterial line at the end of the procedures compared with the group that did not report unexpected predisposing factors for micro-embolic activity. Our clinical analysis showed, therefore, that Horizon AF PLUS is an effective and safe device for the reduction of micro embolic activity during CPBs procedures, with high efficiency in terms of oxygenating performance and thermal exchange, as shown in other series (28,30).…”

Section: Advanced Extracorporeal Techniques and Device Efficiency For...supporting

confidence: 75%

“…These include the absence of a venous reservoir, considerably lowering the priming volume to 200-500 mL after the circuit is retrogradely primed, resulting in minimal hemodilution. This should increase DO2 during bypass (28,30). In this respect, Anastasiadis and colleagues ( 14) suggested a strategy based on continuous monitoring of CI, SvO2, DO2i,DO2i/VCO2i and regional oxygen saturation followed by action when needed.…”

Section: Goal-directed Perfusion During Minimally Invasive Extracorpo...mentioning

confidence: 99%

“…When a microbubble occludes a blood vessel, hypoxia will occur downstream from the blockage. The duration of hypoxia and the deleterious effects of this hypoxia will very much depend on the size and number of GME as well as on the gas composition of these microbubbles (30). The use of new device, specifically designed to hemofiltrate the patient blood and makedly reduce microgaseous emboli.…”

Section: Advanced Extracorporeal Techniques and Device Efficiency For...mentioning

confidence: 99%

“…To summarize, VA-ECMO can be an option for the treatment of various types of shock because it can increase oxygen content and systemic blood flow and eventually increase DO2. Hence, the goal of VA-ECMO is to restore organ blood flow and adequate tissue oxygenation while awaiting recovery, without damaging the lungs or circulation (Figure2)(30).…”

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confidence: 99%

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Effects, management and optimization of extracorporeal techniques and technologies in contemporary cardiac surgery

Condello

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Section: Advanced Extracorporeal Techniques and Device Efficiency For...supporting

confidence: 75%

Section: Goal-directed Perfusion During Minimally Invasive Extracorpo...mentioning

confidence: 99%

Section: Advanced Extracorporeal Techniques and Device Efficiency For...mentioning

confidence: 99%

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confidence: 99%

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Effects, management and optimization of extracorporeal techniques and technologies in contemporary cardiac surgery

Condello

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“…This cannula is validated and certified for retrograde perfusion of the coronary venous sinus in one or more pulmonary veins (up to two). However, despite its effective functionality, we encountered limitations related to the hole shape, small cannula diameter, and potential visual clutter on the surgical field [ 7 , 8 ]. In response to these limitations, we designed a new device for endo-cavitary aspiration and an accompanying system.…”

Section: Methodsmentioning

confidence: 99%

Develop of endocavitary suction device for MiECC on minimally invasive mitral valve surgery

Condello,

Speziale,

Nasso

2024

J Cardiothorac Surg

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The minimally invasive extracorporeal circulation (MiECC) system was developed to minimize the contact of blood with air and foreign surfaces during conventional cardiopulmonary bypass (CPB). It is also aimed to reduce the inflammatory response by further increasing the biocompatibility of the components that make up the MiECC circuits. The Minithoracotomy (MTH) approach for mitral valve disease remains associated with prolonged operative times, but it is beneficial in terms of reduced postoperative complications (renal failure, atrial fibrillation, blood transfusion, wound infection), length of stay in intensive care unit (ICU) and in hospitalization, with finally a reduction in global cost. Combining the use of the MiECC technique with minimally invasive mitral valve surgery (MIMVS) could open up new research scenarios. Although considerable progress has been made in the standardization of the surgical technique, limitations remain to be filled in the setting of Endo-cavitary aspiration for the association of MiECC with MIMVS. In this paper we introduce invention refers to a device and an air-closed endocavitary aspiration system for cardiac chamber surgery, as well as a method aimed at eliminating gaseous micro-embolic activity, hemolysis and CO2 aspiration and alteration of carbon dioxide production (VCO2) the parameters for goal directed perfusion. The system allows the surgery of the cardiac chambers to be associated with a minimally invasive extra-corporeal circulation circuit.

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The effect of air-free administration of intravenous drugs on microemboli during cardiopulmonary bypass

den Ouden,

Stehouwer,

Geurts

et al. 2024

Perfusion

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Objective During cardiopulmonary bypass (CPB), gaseous microemboli (GME) that originate from the extracorporeal circuit are released into the arterial blood stream of the patient. Gaseous microemboli may contribute to adverse outcome after cardiac surgery with CPB. Possibly, air may be collected in the right atrium during induction of anesthesia and released during CPB start. The aim of this study was to assess if the GME load entering the venous line of the CPB circuit could be reduced by training of anesthesia personal in avoiding air introduction during administration of intravenous medication. Methods In 94 patients undergoing coronary artery bypass grafting with CPB, GME number and volume were measured intraoperatively with a bubble counter (BCC300). The quantity and the relationship between GME number and volume in the venous and arterial line were determined in 2 periods before and after education of the anesthesiologists and nurses. Results In the venous line no significant differences were observed between numbers and volumes of GME between groups. Comparing patients with low versus high GME load, showed significantly more patients from the intervention group in the low GME-load group, namely 29 versus 18. Administration of medication by anesthesia was confirmed as a clear cause of GME/air-introduction into the venous circulation. Scavenging properties of the CPB circuit including the oxygenator showed a 99.9% reduction of GME. Conclusions A wide spread of GME generation during perfusion was present with no difference in generation of GME between groups. Lower GME load observed in patients (intervention group) and examples of air introduction during drug administration suggest that air introduced by anesthesia contributes to the GME load during CPB. Scavenging properties of the CPB circuit contribute very much to patient safety regarding reduction of venous air. Awareness and education create the possibilities for further reduction of GME during cardiopulmonary bypass.

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Arterial and Venous Air Emboli in Health Care

Cited by 4 publications

References 42 publications

Effects, management and optimization of extracorporeal techniques and technologies in contemporary cardiac surgery

Effects, management and optimization of extracorporeal techniques and technologies in contemporary cardiac surgery

Develop of endocavitary suction device for MiECC on minimally invasive mitral valve surgery

The effect of air-free administration of intravenous drugs on microemboli during cardiopulmonary bypass

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