In vitro elimination of gaseous microemboli utilizing hypobaric oxygenation in the Terumo<sup>®</sup> FX15 oxygenator

Clingan, Sean; Schuldes, Matthew; Francis, Stephen G; Hoerr, Harry R.; Riley, J. B.

doi:10.1177/0267659116638148

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…Воздушная микроэмболия (ВМ) сопровождается блокировкой микрососудов жизненно важных органов и может возникнуть при использовании как аппаратов искусственного кровообращения (АИК), так и экстракорпоральных систем поддержки кровообращения. До сих пор ВМ остается серьезной проблемой, наиболее критичной для микрососудов мозга [1][2][3].…”

Section: Introductionunclassified

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Kuleshov

Бучнев

Drobyshev

et al. 2021

RJTAO

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The use of extracorporeal circulation systems (cardiopulmonary bypass pumps, ECMO) can lead to brain and coronary artery microembolism, which significantly reduces postoperative rehabilitation and often leads to severe complications. Microembolism occurs when oxygen or air microbubbles (MBs) enter the arterial system of patients. Existing CPB pumps come with built-in bubble trap systems but cannot remove bubbles in the circuit. ECMO devices have arterial filters but cannot reliably filter out <40 μm bubbles in a wide flow range. We have proposed an alternative method that involves the use of an efficient dynamic bubble trap (DBT) for both large and small bubbles. The design includes development of two DBT variants for hemodynamic conditions of adult and pediatric patients. The device is installed in the CPB pump and ECMO outlet lines. It provides sufficient bubble separation from the lines in a blood flow of 3.0–5.0 L/min for adults and 0.5–2.0 L/min for children. The developed computer models have shown that MBs smaller than 10 μm can be filtered. The use of this device will greatly reduce the likelihood of air embolism and provide the opportunity to reconsider the concept of expensive arterial filters.

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Section: Introductionunclassified

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Kuleshov

Бучнев

Drobyshev

et al. 2021

RJTAO

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Organ Perfusion and Cardiopulmonary Bypass Techniques

Koehler

Grady

Ochocki

et al. 2022

Advances in Cardiovascular Technology

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Effect of Normobaric versus Hypobaric Oxygenation on Gaseous Microemboli Removal in a Diffusion Membrane Oxygenator: An In Vitro Comparison

Schuldes

Riley

Francis

et al. 2016

J Extra Corpor Technol

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Gaseous microemboli (GME) are an abnormal physiological occurrence during cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO). Several studies have correlated negative sequelae with exposure to increased amounts of GME. Hypobaric oxygenation is effective at eliminating GME in hollow-fiber microporous membrane oxygenators. However, hollow-fiber diffusion membrane oxygenators, which are commonly used for ECMO, have yet to be validated. The purpose of this study was to determine if hypobaric oxygenation, compared against normobaric oxygenation, can reduce introduced GME when used on diffusion membrane oxygenators. Comparison of a sealed Quadrox-iD with hypobaric sweep gas (.67 atm) vs. an unmodified Quadrox-iD with normal atmospheric sweep gas (1 atm) in terms of GME transmission during continuous air introduction (50 mL/min) in a recirculating in vitro circuit, over a range of flow rates (3.5, 5 L/min) and crystalloid prime temperatures (37°C, 28°C, and 18°C). GME were measured using three EDAC Doppler probes positioned pre-oxygenator, post-oxygenator, and at the arterial cannula. Hypobaric oxygenation vs. normobaric oxygenation significantly reduced hollow-fiber diffusion membrane oxygenator GME transmission at all combination of pump flows and temperatures. There was further significant reduction in GME count between the oxygenator outlet and at the arterial cannula. Hypobaric oxygenation used on hollow-fiber diffusion membrane oxygenators can further reduce GME compared to normobaric oxygenation. This technique may be a safe approach to eliminate GME during ECMO.

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In vitro elimination of gaseous microemboli utilizing hypobaric oxygenation in the Terumo^® FX15 oxygenator

Abstract: Correlation between the use of hypobaric oxygenation and GME counts suggests hypobaric oxygenation could play a significant role in the reduction of GME.

Cited by 6 publications

References 17 publications

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Organ Perfusion and Cardiopulmonary Bypass Techniques

Effect of Normobaric versus Hypobaric Oxygenation on Gaseous Microemboli Removal in a Diffusion Membrane Oxygenator: An In Vitro Comparison

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In vitro elimination of gaseous microemboli utilizing hypobaric oxygenation in the Terumo® FX15 oxygenator

Abstract: Correlation between the use of hypobaric oxygenation and GME counts suggests hypobaric oxygenation could play a significant role in the reduction of GME.

Cited by 6 publications

References 17 publications

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Design and 3D-model of a dynamic bubble trap for cardiopulmonary bypass

Organ Perfusion and Cardiopulmonary Bypass Techniques

Effect of Normobaric versus Hypobaric Oxygenation on Gaseous Microemboli Removal in a Diffusion Membrane Oxygenator: An In Vitro Comparison

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Product

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In vitro elimination of gaseous microemboli utilizing hypobaric oxygenation in the Terumo^® FX15 oxygenator