title: Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter.
abstract: Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery. The arterial filter is a specially designed component for removing both gaseous and solid microemboli. Integration of an arterial filter with an oxygenator is a contemporary concept, reducing both prime volume and foreign surface area. This study aims to determine the air-handling properties of four contemporary oxygenator devices with an integrated arterial filter. Two oxygenator devices, the Capiox FX25 and the Fusion, showed significant increased volume of GME reduction rates (95.03 ± 3.13% and 95.74 ± 2.69%, respectively) compared with both the Quadrox-IF (85.23 ± 5.84%) and the Inspire 6F M (84.41 ± 12.93%). Notably, both the Quadrox-IF and the Inspire 6F M as well as the Capiox FX 25 and the Fusion showed very similar characteristics in volume and number reduction rates and in detailed distribution properties. The Capiox FX25 and the Fusion devices showed significantly increased number and volume reduction rates compared with the Quadrox-IF and the Inspire 6F M devices. Despite the large differences in design of all four devices, our study results suggest that the oxygenator devices can be subdivided into two groups based on their fibre design, which results in screen filter (Quadrox-IF and Inspire 6F M) and depth filter (Capiox FX25 and Fusion) properties. Depth filter properties, as present in the Capiox FX25 and Fusion devices, reduced fractionation of air and may ameliorate GME removal.
authors: 1 Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein, The Netherlands.
authors: Marco C
authors: MC
authors: Stehouwer
authors: 1 Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein, The Netherlands.
authors: Kristina R
authors: KR
authors: Legg
authors: 2 Department of Extracorporeal Circulation, HAGA Hospital, The Hague, The Netherlands.
authors: Roel
authors: R
authors: de Vroege
authors: 3 Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
authors: Johannes C
authors: JC
authors: Kelder
authors: 4 Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
authors: Erik
authors: E
authors: Hofman
authors: 5 Section Cardiovascular Biomechanics, Faculty of Biomedical Technology, Technical University Eindhoven, Eindhoven, The Netherlands.
authors: Bastian A
authors: BA
authors: de Mol
authors: 6 Department of Anaesthesiology, Intensive Care and Pain Management, St Antonius Hospital, Nieuwegein, The Netherlands.
authors: Peter
authors: P
authors: Bruins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D057505:Embolic Protection Devices; D004618:Embolism, Air / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010106:Oxygenators / Q000009:adverse effects; D011446:Prospective Studies
keywords: cardiopulmonary bypass; clinical evaluation; design; gaseous microemboli; oxygenators