Clinical evaluation of emboli removal by integrated versus non-integrated arterial filters in new generation oxygenators

Jabur, Ghazwan Ns; Sidhu, Karishma; Willcox, Timothy W.; Mitchell, Simon J

doi:10.1177/0267659115621614

Cited by 17 publications

(15 citation statements)

References 20 publications

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“…150 mL, may lead to an improved clinical outcome. 11 Recently, Jabur et al 19 compared air removal rates of integrated and non-integrated oxygenator-filter combinations in a clinical setting. They also included the Sorin 6F M, the Capiox FX25 and the Fusion devices.…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter

et al. 2016

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Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery. The arterial filter is a specially designed component for removing both gaseous and solid microemboli. Integration of an arterial filter with an oxygenator is a contemporary concept, reducing both prime volume and foreign surface area. This study aims to determine the air-handling properties of four contemporary oxygenator devices with an integrated arterial filter. Two oxygenator devices, the Capiox FX25 and the Fusion, showed significant increased volume of GME reduction rates (95.03 ± 3.13% and 95.74 ± 2.69%, respectively) compared with both the Quadrox-IF (85.23 ± 5.84%) and the Inspire 6F M (84.41 ± 12.93%). Notably, both the Quadrox-IF and the Inspire 6F M as well as the Capiox FX 25 and the Fusion showed very similar characteristics in volume and number reduction rates and in detailed distribution properties. The Capiox FX25 and the Fusion devices showed significantly increased number and volume reduction rates compared with the Quadrox-IF and the Inspire 6F M devices. Despite the large differences in design of all four devices, our study results suggest that the oxygenator devices can be subdivided into two groups based on their fibre design, which results in screen filter (Quadrox-IF and Inspire 6F M) and depth filter (Capiox FX25 and Fusion) properties. Depth filter properties, as present in the Capiox FX25 and Fusion devices, reduced fractionation of air and may ameliorate GME removal.

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Section: Discussionmentioning

confidence: 99%

Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter

et al. 2016

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“…[18] A recent study reported that the oxygenators without integrated filters exhibited the highest degree of emboli-trapping capabilities, although they found no disadvantage for oxygenators with integrated filters. [19] The present study compared newly emerging embolic foci in cerebral diffusion-weighted MRI studies pre-and postoperatively in patients undergoing CABG using oxygenators with or without integrated arterial filters. Cerebral silent infarctions known to occur after cardiac procedures can be readily detected using diffusion-weighted MRI.…”

Section: Discussionmentioning

confidence: 99%

The impact on neurological outcomes with the new-generation membrane oxygenators with integrated arterial filters

Erkin¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, koroner arter baypas greftleme yapılan hastalarda, kardiyopulmoner baypasta kullanılan iki farklı oksijenatör sistemi olan, membran oksijenatöre entegreli ve entegresiz arteriyel filtrenin nörokognitif etkileri karşılaştırıldı.Ça lış ma pla nı: Bu prospektif, randomize çalışmaya Ocak 2015 -Aralık 2015 tarihleri arasında elektif koroner arter baypas greftleme yapılan toplam 40 hasta (36 erkek, 4 kadın; ort. yaş 60.0±8.5; dağılım 43-75 yıl) alındı. Hastalar kapalı zarf tekniği kullanılarak blok randomizasyon ile iki gruba ayrıldı. Grup 1'de arteriyel filtre entegresiz membran oksijenatörleri ve grup 2'de arteriyel filtre entegreli membran oksijenatörleri kullanıldı. Tüm hastalarda ameliyat sırasında serebral oksijenizasyon yakın kızılötesi spektroskopi ile değerlendirildi. Cerrahi işlemden 2-4 gün önce ve sonra, beyin difüzyon ağırlıklı manyetik rezonans görüntüleme yapıldı. Bilişsel fonksiyonlar ameliyat sonrası birinci ayda Montreal Bilişsel Değerlendirme testi ile değerlendirildi.Bul gu lar: Difüzyon ağırlıklı manyetik rezonans görüntülemede entegresiz grupta 11 hastada ve entegreli grupta yedi hastada yeni lezyonlar saptandı. Ameliyat öncesi ve sonrası toplam Montreal Bilişsel Değerlendirme skoru entegresiz ve entegreli grupta sırasıyla ortalama 27.9±3.3'e kıyasla 28.1±3.4 ve 26.2±3.1'e kıyasla 26.8±3 idi. Gruplar arasında yeni lezyon sayısı, yakın kızılötesi spektroskopi bulguları ve Montreal Bilişsel Değerlendirme skorları açısından istatistiksel olarak anlamlı bir fark yoktu.So nuç:Arteriyel filtre entegreli membran oksijenatörlerin, koroner arter baypas greftleme yapılan hastalarda, nörokognitif sonuçlar açısından, arteriyel filtresi entegre olmayan membran oksijenatörlere kıyasla, anlamlı bir üstünlükleri var gibi görünmemektedir.Anah tar söz cük ler: Bilişsel fonksiyonlar; difüzyon ağırlıklı manyetik rezonans görüntüleme; membran oksijenatörler. ABSTRACTBackground: This study aims to compare the neurocognitive effects of two different oxygenator systems, i.e. membrane oxygenator with or without integrated arterial filters, used during cardiopulmonary bypass in patients undergoing coronary artery bypass grafting.

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“…The technological breakthrough of the HLM was challenged by a number of technological and biological umprecedented problems related to the new interactions between machines and the human body. New materials and new technology resulted in sophisticated devices incorporating better pump heads, biocompatible surfaces for cardiopulmonary bypass tubing aiming at reducing inflammatory response [24] , multiple in-line sensors for better safety, more effective and less traumatic oxygenators with superior performance [25] , in-line filters of all kinds [26,27] , hemoadsorbers [28] and other complements that allowed safer conduct of cardiopulmonary bypass for repair of cardiac disease.…”

Section: The Challenges and The Frontiermentioning

confidence: 99%

The frontier in Cardiac Surgery is intellectual

Mestres¹,

Pozzoli²,

Taramasso³

et al. 2019

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Cardiac Surgery is a Specialty undergoing profound changes. Since its inception, innovation has been at the forefront of activities seeking for the best of the patients. The introduction of the heart-lung machine in clinical practice in the 1950s of the twentieth century allowed for the correction of intra-and extracardiac defects. The recent past two decades have seen the progressive incorporation of transcatheter therapies to treat a variety of heart defects. Multimodality imaging approach has become a fundamental tool in the pre-intra-and postoperative assessment of patients. The future in Cardiac Surgery contemplates redesigning training programs with the mandatory acquisition of catheter skills, the knowledge of the different imaging modalities and allocation of resources and timing for basic and translational research.

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Clinical evaluation of emboli removal by integrated versus non-integrated arterial filters in new generation oxygenators

Cited by 17 publications

References 20 publications

Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter

Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter

The impact on neurological outcomes with the new-generation membrane oxygenators with integrated arterial filters

The frontier in Cardiac Surgery is intellectual

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