title: Potential impact of oxygenators with venous air trap on air embolism in veno-arterial Extracorporeal Life Support.
abstract: BACKGROUND
  Air embolism is a potentially fatal but underrecognized complication in Extracorporeal Life Support (ECLS). Oxygenators containing venous air traps have been developed to minimize the risk of air embolism in daily care.
  
  
  OBJECTIVE
  We reproduced air embolism as occurring via a central venous catheter in an experimental setting to test the potential of oxygenators with and without venous bubble trap (VBT) to withhold air.
  
  
  METHODS
  An in vitro ECLS circuit was created and a central venous catheter with a 3-way stopcock and a perforated male luer cap was inserted into the inflow line. Three different oxygenators with and without VBT and their capability to withhold air were examined. After 60 seconds of stable ECLS flow, the stopcock was opened towards the atmosphere for 3 minutes. Afterwards, air accumulation within the oxygenator was determined.
  
  
  RESULTS
  Comparison of the total air entrapment showed a significant superiority of the oxygenators with VBT (p < 0.001). All oxygenators were able to partly withhold macro air boli, however, the capacity of oxygenators with VBT was higher. Passing through the oxygenator resulted in a reduction of microbubbles in all cases.
  
  
  CONCLUSIONS
  Macro air emboli can be substantially reduced by usage of oxygenators that contain a VBT, whereas the capability to withhold microbubbles to a vast extent seems to depend on the intrinsic oxygenator's membrane.
authors: Frank
authors: F
authors: Born
authors: Nawid
authors: N
authors: Khaladj
authors: Maximilian
authors: M
authors: Pichlmaier
authors: René
authors: R
authors: Schramm
authors: Christian
authors: C
authors: Hagl
authors: Sabina P W
authors: SP
authors: Guenther
mesh_terms: D004618:Embolism, Air / Q000517:prevention & control*; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D010106:Oxygenators; D013997:Time Factors
keywords: Air embolism; extracorporeal life support; oxygenator; venous bubble trap