Issue |
J Extra Corpor Technol
Volume 39, Number 3, September 2007
|
|
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Page(s) | 192 - 198 | |
DOI | https://doi.org/10.1051/ject/200739192 | |
Published online | 15 September 2007 |
Abstract
Preventing Gaseous Microemboli During Blood Sampling and Drug Administration: An In Vitro Investigation
Address correspondence to: Gerard J. Myers, Cardiovascular Perfusion Services, Cardiac OR, NHI Campus, QEII Health Sciences Center, 1796 Summer Street, Halifax, Nova Scotia, Canada B3K 6A3. E-mail: edit@ns.sympatico.ca
The detection and prevention of gaseous microemboli (GMEs) during cardiopulmonary bypass has generated considerable interest within the cardiac surgical community. There have been several landmark papers that have used transcranial Doppler devices during cardiopulmonary bypass to detect gaseous microemboli activity in the patients’ middle cerebral artery during perfusionist interventions. To determine if this source of emboli could be prevented, a shunt was developed between the oxygenator’s sampling manifold and the oxygenator’s venous line. This shunt bypassed the venous line and emptied into the oxygenator’s integral cardiotomy. An in vitro experiment was performed using three open system oxygenators (Sorin Synthesis, Sorin PrimeOx2, and Terumo Capiox SX25) to compare post-arterial filter emboli detection using the Hatteland CMD20 Microbubble Detector under tightly controlled conditions. After injection of air through the sampling manifold, the PrimeOx2 and the Synthesis oxygenators had statistically significant fewer GMEs with the shunt used than when the shunt was not used. Using a shunt in the sampling manifold during perfusionist interventions will dramatically reduce or eliminate gaseous microemboli transmission to the patient during bypass with both the PrimeOx2 and Synthesis oxygenators. However, results indicate that further study of GME handling with all oxygenator’s integral cardiotomies is warranted.
Key words: gaseous microemboli / oxygenator / perfusionist / cardiopulmonary bypass
© 2007 AMSECT
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