title: Effect of Oxygenator Size on Air Removal Characteristics: A Clinical Evaluation.
abstract: During cardiopulmonary bypass (CPB), gaseous microemboli (GME) are released into the patients' arterial bloodstream. Gaseous microemboli may contribute to the adverse outcome after cardiac surgery. Recently, two oxygenator models with or without integrated arterial filter (IAF) were designed and only differ in size, leading to a change of 20% in surface area of the hollow fibers and 25% in blood velocities. The aim of this study was to assess the air removal characteristics of the inspire oxygenators with or without IAF. Sixty-eight patients were randomly assigned to four different groups: optimized adult and full adult and an additional IAF. Gaseous microemboli reduction rates were measured with a bubble counter. The number of GME reduction rates showed no differences. However, both models reduced significantly less volume of GME (optimized adult: 40.6% and full adult: 50.3%) compared with both models with IAF (88.7% and 88.5%, respectively). No significant differences of reduction rates were found between both devices without IAF and also not between both models with IAF. In conclusion, the larger inspire oxygenator tends to remove more GME. No effect from size of oxygenator device with integrated screen filter on GME reduction was observed. The inspire oxygenators with IAF may be considered as an adequate GME filter.
authors.affiliation: From the *Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein, The Netherlands; †Department of Extracorporeal Circulation, HAGA Hospital, The Hague, The Netherlands; ‡Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands; §Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands; ¶Section Cardiovascular Biomechanics, Faculty of Biomedical Technology, Technical University Eindhoven, Eindhoven, The Netherlands; and ‖Department of Anaesthesiology, Intensive Care and Pain Management, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Marco C
authors.initials: MC
authors.lastname: Stehouwer
authors.forename: Roel
authors.initials: R
authors.lastname: de Vroege
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Kelder
authors.forename: Frederik N
authors.initials: FN
authors.lastname: Hofman
authors.forename: Bastian A
authors.initials: BA
authors.lastname: de Mol
authors.forename: Peter
authors.initials: P
authors.lastname: Bruins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004618:Embolism, Air / Q000517:prevention & control*; D005260:Female; D005374:Filtration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010106:Oxygenators