Microemboli Detection and Classification During Pediatric Cardiopulmonary Bypass

Joseph B. Clark, Feng Qiu, Yulong Guan, Karl R. Woitas, John L. Myers, Akif Undar

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Microemboli may be a cause of postoperative neurological morbidity. Improved detection of microemboli may lead to better strategies to minimize embolization and improve neurological outcomes. Transcranial Doppler may have limited sensitivity for very small microemboli. The Emboli Detection and Classification (EDAC) Quantifier offers increased sensitivity (10 μm) and potentially improved capability for microemboli monitoring. EDAC was used to measure microemboli in the cardiopulmonary bypass circuit during 33 pediatric heart operations. More microemboli were detected in the venous than the arterial line (median, 11,830 vs 1298). Venous microemboli tended to be larger in size than arterial microemboli (>40 μm; 59% vs 7%). Increased venous and arterial microemboli were seen at the onset of bypass; increased venous microemboli were also seen with clamp removal. Thousands of microemboli <40 μm are transmitted to pediatric patients during heart surgery. Initiation of bypass may be a key offender and may result from air in the venous line. Although the significance of microemboli remains unknown, increased awareness may lead to improved techniques to minimize microemboli, with improvement in neurological outcomes.

Original languageEnglish (US)
Pages (from-to)111-114
Number of pages4
JournalWorld Journal for Pediatric and Congenital Heart Surgery
Volume2
Issue number1
DOIs
StatePublished - Jan 2011

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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