Microemboli detection and classification by innovative ultrasound technology during simulated neonatal cardiopulmonary bypass at different flow rates, perfusion modes, and perfusate temperatures

Robert S. Schreiner, Alan R. Rider, John W. Myers, Bingyang Ji, Allen Kunselman, John Myers, Akif Undar

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32 Scopus citations

Abstract

The objective of this study was to detect and classify the number and size of gaseous microemboli in a simulated pediatric model of cardiopulmonary bypass. Tests were conducted at five different flow rates (400 1,200 ml/min in 200 ml/min increments), pulsatile versus nonpulsatile perfusion modes, and under normothermic, hypothermic, and deep hypothermic (35°C, 25°C, and 15°C) conditions, yielding 180 total experiments. The circuit was primed with lactated Ringer's solution and filled with heparinized bovine blood. At the beginning of each experiment, 5 ml of air were injected into the venous line via the luer port of the oxygenator. Microemboli were quantified and classified by size for 5 minute segments at three transducer sites: postpump, postoxygenator, and postarterial filter. The purge line of the arterial filter was closed during all experiments. In all but one experiment, 90% of emboli at the postpump site were found to be smaller than 40 m. At the postarterial filter site, nearly 99% of the emboli were smaller than 40 m. Additionally, increasing microemboli counts were observed when the flow rate was increased and when the temperature was decreased. Lower temperatures, higher flow rates, and pulsatile perfusion were all associated with higher emboli counts. The majority of gaseous microemboli found in the simulated circuit was significantly below 40 m; the smallest level detectable by traditional Doppler devices. ASAIO Journal 2008; 54:316-324.

Original languageEnglish (US)
Pages (from-to)316-324
Number of pages9
JournalASAIO Journal
Volume54
Issue number3
DOIs
StatePublished - May 1 2008

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All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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