Doppler Ultrasound Estimation of Bubble Removal by Various Arterial Line Filters During Extracorporeal Circulation

Semb, Bjarne K. H.; Pedersen, Tore; Hatteland, K; Storstein, Liv; Lilleaasen, Per

doi:10.3109/14017438209100610

Cited by 23 publications

(8 citation statements)

References 12 publications

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“…In addition, pH-stat management was associated with greater CBF relative to alpha-stat and impairment of cerebral autoregulation [16,17]. An increased PaCO 2 value could increase the embolic load to the brain because of the increased cerebral blood ow [18], but the use of membrane oxygenators [19,20] with arterial line ®lters [21,22] has reduced the incidence of microembolization. In addition, most embolization occurs with aortic canulation (before the initiation of CPB), at the onset of CPB, after the release of aortic cross-clamp, and during the early phase of ventricular ejection (before the end of CPB) [23,24] and it might be possible to reduce PaCO 2 level during these periods [18].…”

Section: Discussionmentioning

confidence: 99%

Changes in jugular bulb oxygenation in patients undergoing warm coronary artery bypass surgery (34-37oC)

et al. 2001

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We found that jugular bulb oxygen saturation, jugular bulb oxygen tension and oxygen extraction ratio are mainly dependent on arterial carbon dioxide tension, and arterial-jugular bulb oxygen content difference is dependent on arterial carbon dioxide tension and the bypass temperature. Our results suggest jugular bulb oxygenation is mainly dependent on arterial carbon dioxide tension during warm cardiopulmonary bypass.

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Section: Discussionmentioning

confidence: 99%

Changes in jugular bulb oxygenation in patients undergoing warm coronary artery bypass surgery (34-37oC)

et al. 2001

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“…The use of ultrasonic techniques by numerous investigators has confirmed that a principal advantage of arterial filtration is the removal of GME and gross air. 44,45,47,73,78,81,133,137,145,223,235 Overviews of the general theories involved in the GME removal by various bubble traps and filters are described by Galletti and Brecher236 and Pascale.237 Newer information regarding the incidence of cerebrovascular microembolism, assessed by retinal fluorescein angiography, has clearly demonstrated a reduced incidence of vascular occlusions in patients perfused with a flat-plate membrane oxygenator when compared to those perfused with a bubble oxygenator.238 While the number of patients in each group of this report was small, the author suggests less neuropsychological deficits in the membrane oxygenator group. This study, and the more general acceptance of membrane oxygenators for routine CPB in the last few years, indicate that a reduction in the use of a major source of GME (i.e.…”

Section: Clinical Consequencesmentioning

confidence: 99%

“…135,137,145 There has also been an increased emphasis on newer design filters that take advantage of fluid dynamics to separate and remove GME from the blood.239…”

Section: Clinical Consequencesmentioning

confidence: 99%

Review article : Gaseous microemboli: a review

Butler

Kurusz

1990

Perfusion

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“…A pulsed Doppler ultrasound system, the CMD10 (Hatteland Instrumentering, Ryken, Norway) [10][11][12] was connected to the arterial line 3 inches downstream of the filter to measure bubble intensity and relative bubble size of the perfusate. A 13-mm inner diameter probe, fitting 3/8-inch tubing, was used and ultrasonic gel was applied to ensure an optimal contact between the probe and the tubing.…”

Section: Equipmentmentioning

confidence: 99%

Ex vivo testing of the Quart® arterial line filter

et al. 1999

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Arterial line filters are now routinely used in cardiac surgery in order to decrease the microemboli load to the patient. The Quart filter (Jostra, Hirrlingen, Germany) with a new planar construction design, an easy de-airing system and an integrated bypass, was tested for air filtration capacity and resistance to blood path in a standardized setting with surviving animals. Three calves (mean body weight: 71+/-3.4 kg) were connected to a standard cardiopulmonary bypass (CPB) circuit by jugular venous and carotid arterial cannulation with a mean flow rate of 3.5 l/min. The arterial line filter was challenged with upstream injections of boluses of air of 5, 10 and 15 ml, respectively. A Doppler ultrasound was positioned downstream on the arterial line to measure bubble count and size. The pressure drop through the filter was monitored at flow rates of between 1 and 6 l/min. At the end of the procedure the animals were weaned from the CPB and, thereafter, from the ventilator. After 7 days, the animals were sacrificed electively. This study shows that important quantities of air can be injected into the arterial line upstream of the filter with small volumes of small sized bubbles recorded downstream. With the 5 ml air bolus injection, mean values of 0.3+/-0.6 bubbles of 30 and 40 microm were detected, whereas with the 20 ml bolus, 32.6+/-8.7 bubbles of 10 microm, 3.7+/-1.1 bubbles of 30 microm, 3.3+/-0.6 bubbles of 40 microm and 0.7+/-1.1 bubbles of 50 microm were recorded. The blood path resistance at different blood flow rates was well within the acceptable range with a pressure drop of 20+/-0 and 26.6+/-5.7 mmHg at flow rates of 4 and 5 l/min, respectively. With its planar concept, the Quart filter offers good air filtering capacity both in terms of bubble count and size after injection of large boluses of air, without any increase of resistance to the blood path. Moreover, it offers a venting function and an integrated bypass system.

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Doppler Ultrasound Estimation of Bubble Removal by Various Arterial Line Filters During Extracorporeal Circulation

Cited by 23 publications

References 12 publications

Changes in jugular bulb oxygenation in patients undergoing warm coronary artery bypass surgery (34-37oC)

Changes in jugular bulb oxygenation in patients undergoing warm coronary artery bypass surgery (34-37oC)

Review article : Gaseous microemboli: a review

Ex vivo testing of the Quart® arterial line filter

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