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Clinical evaluation of the air removal characteristics of an oxygenator with integrated arterial filter in a minimized extracorporeal circuit

Abstract

The use of minimized extracorporeal circuits (MECC) in cardiac surgery is an important measure to increase the biocompatibility of cardiopulmonary bypass during coronary artery bypass grafting (CABG). These circuits eliminate volume storage reservoirs and bubble traps to minimize the circuit. However, the reduction in volume may increase the risk of gaseous microemboli (GME). The MECC system as used by our group consists of a venous bubble trap, centrifugal pump, and an oxygenator. To further reduce the risk of introducing GME, an oxygenator with an integrated arterial filter was developed based on the concept of minimal volume and foreign surface. We studied the air removal characteristics of this oxygenator with and without integrated arterial filter. The quantity and volume of GME were measured with precision at both the inlet and outlet of the devices. Our results showed that integration of an arterial filter into this oxygenator increased GME reducing capacity from 69.2% to 92%. Moreover, we were able to obtain data on the impact of an arterial filter on the exact size-distribution of GME entering the arterial line. The present study demonstrates that an MECC system and oxygenator with integrated arterial filter significantly reduces the volume and size of GME. The use of an integrated arterial filter in an MECC system may protect the patient from the deleterious effects of CPB and may further improve patient safety.

Int J Artif Organs 2011; 34(4): 374 - 382

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/IJAO.2011.7749

Authors

Marco C. Stehouwer, Chris Boers, Roel de Vroege, Johannes C. Kelder, Alaaddin Yilmaz, Peter Bruins

Article History

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Authors

  • Stehouwer, Marco C. [PubMed] [Google Scholar]
    Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein - The Netherlands
  • Boers, Chris [PubMed] [Google Scholar]
    Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein - The Netherlands
  • de Vroege, Roel [PubMed] [Google Scholar]
    Department of Extracorporeal Circulation, HAGA Hospital, The Hague - The Netherlands
  • C. Kelder, Johannes [PubMed] [Google Scholar]
    Department of Cardiology, St Antonius Hospital, Nieuwegein - The Netherlands
  • Yilmaz, Alaaddin [PubMed] [Google Scholar]
    Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein - The Netherlands
  • Bruins, Peter [PubMed] [Google Scholar]
    Department of Anesthesiology, Intensive Care and Pain Management, St Antonius Hospital, Nieuwegein - The Netherlands

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