Arterial-line filters used during extracorporeal circulation continue to rely on the physical properties of a wetted micropore and reductions in blood flow velocity to affect air separation from the circulating blood volume. Although problems associated with air embolism during cardiac surgery persist, a number of investigators have concluded that further improvements in filtration are needed to enhance air removal during cardiopulmonary bypass procedures. This article reviews theoretical principles of micropore filter technology and outlines the development of a new arterial-line filter concept using computational fluid dynamics analysis. Manufacturer-supplied data of a micropore screen and experimental results taken from an ex vivo test circuit were used to define the inputs needed for numerical modeling of a new filter design. Flow patterns, pressure distributions, and velocity profiles predicted with computational fluid dynamics softwarewere used to inform decisions on model refinements and how to achieve initial design goals of ≤225 mL prime volume and ≤500 cm2 of screen surface area. Predictions for optimal model geometry included a screen angle of 56° from the horizontal plane with a total surface area of 293.9 cm2 and a priming volume of 192.4 mL. This article describes in brief the developmental process used to advance a new filter design and supports the value of numerical modeling in this undertaking.

Improvements in micropore arterial line filter designs used for extracorporeal circulation are still needed because microbubbles larger than the rated pore sizes are being detected beyond the filter outlet. Linked to principles governing the function of micropore filters, fluid pressures contained in extracorporeal circuits also influence the behavior of gas bubbles and the extent to which they are carried in a fluid flow. To better understand the relationship between pressure and microbubble behavior, two ex vivo test circuits with and without inline resistance were designed to assess changes in microbubble load with changes in pressure. Ultrasound Doppler probes were used to measure and compare the quality and quantity of microbubbles generated in each test circuit. Analysis of microbubble load was separated into two distinct phases, the time periods during and immediately after bubble generation. Although microbubble number decreased similarly in both test circuits, changes in microbubble volume were significant only in the test circuit with inline resistance. The test circuit with inline resistance also showed a decrease in the rate of volume transferred across each ultrasound Doppler probe and the microbubble number and size range measured in the postbubble generation period. The present research proposes that fluid pressures contained in extracorporeal circuits may be used to affect gases in solution as a possible method to improve microbubble filtration during extracorporeal circulation.

Micropore filters are used during extracorporeal circulation to prevent gaseous and solid particles from entering the patient’s systemic circulation. Although these devices improve patient safety, limitations in current designs have prompted the development of a new concept in micropore filtration. A prototype of the new design was made using 40-μm filter screens and compared against four commercially available filters for performance in pressure loss and gross air handling. Pre- and postfilter bubble counts for 5- and 10-mL bolus injections in an ex vivo test circuit were recorded using a Doppler ultrasound bubble counter. Statistical analysis of results for bubble volume reduction between test filters was performed with one-way repeated-measures analysis of variance using Bonferroni post hoc tests. Changes in filter performance with changes in microbubble load were also assessed with dependent t tests using the 5- and 10-mL bolus injections as the paired sample for each filter. Significance was set at p < .05. All filters in the test group were comparable in pressure loss performance, showing a range of 26–33 mmHg at a flow rate of 6 L/min. In gross air-handling studies, the prototype showed improved bubble volume reduction, reaching statistical significance with three of the four commercial filters. All test filters showed decreased performance in bubble volume reduction when the microbubble load was increased. Findings from this research support the underpinning theories of a sequential arterial-line filter design and suggest that improvements in microbubble filtration may be possible using this technique.

The process of microbubble filtration from blood is complex and highly dependent on the forces of flow and buoyancy. To protect the patient from air emboli, arterial-line filters commonly use a micropore screen, a large volume housing with purpose-built shape, and a purge port to trap, separate, and remove circulating microbubbles. Although it has been proposed that an insufficient buoyancy force renders the purge port ineffective at removing microbubbles smaller than 500 μm, this research attempts to investigate the purge flow of an arterial-line filter to better understand the microbubble removal function in a typical radial filter design. As its primary objective, the study aims to determine the effect of purge-flow rate on bubble capture using air bolus injections from a syringe pump with 22-gauge needle and Doppler ultrasound bubble detection. The measureable bubble size generated in the test circuit ranged between 30 and 500 μm, while purge flow was varied between .1 and .5 L/min for testing. Statistical analysis of the test data was handled using a repeated measures design with significance set at p < .05 level. Outcomes demonstrated that higher purge flows yielded higher bubble counts, but the effect of purge-flow rate on bubble capture decreased as bubble size increased. Results also showed that purge flow from the test filter was capable of capturing all bubble sizes being generated over the entire flow range tested, and confirms utility of the purge port in removing microbubbles smaller than 500 μm. By analyzing bubble counts in the purge flow of a typical radial-filter design, this study demonstrates that currently available micropore filter technology is capable of removing the size range of bubbles that commonly pass through modern pump-oxygenator systems and should continue to be considered during extracorporeal circulation as a measure to improve patient safety.

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