New Method of Injured Nerve Repair

2017 ◽  
Vol 79 (04) ◽  
pp. 291-295 ◽  
Author(s):  
Alina Korsak ◽  
Volodymyr Likhodiievskyi ◽  
Yuri Chaikovsky ◽  
Liudmyla Sokurenko
Keyword(s):  
Spinal Cord ◽  
Sciatic Nerve ◽  
Motor Center ◽  
Electric Welding ◽  
Injured Nerve ◽  
Welding Technology ◽  
Reactive Changes ◽  
S 100 ◽  
Group 3 ◽  
Group 2

Background Innovative surgical techniques form the basis of therapeutic approaches to address the negative consequences of nerve damage. This study evaluated the effectiveness of nerve trunk regeneration after the use of an electrosurgical instrument by looking at the patterns of morphological changes in the injured nerve and the structural elements of the segment motor center. Methodology The study was performed on male Wistar rats divided into four groups: group 1, control; group 2, rats with simulated sciatic nerve injury with epineural sutures; 3, rats subjected to an experimental surgical procedure using high-frequency electric welding technology; and 4, rats with simulated sciatic nerve injury without posttransection repair. To study changes in the peripheral stump of the transected nerves and L5 segments of the spinal cord, we used histologic, immunohistochemical, and morphometric methods. Results At week 12 after the surgery, there were more S-100+ Schwann cells, increased expression of neurofilaments (NFs), and glial fibrillary acidic protein in the peripheral stump in group 3 than in groups 2 and 4, which indicates enhanced neurotization and myelination. Group 3 animals demonstrated reduced expression of S-100 and NFs in the motor center of the spinal cord compared with group 2 that suggests less pronounced reactive changes caused by electric welding technology. Conclusions The study showed a novel surgical method using an electrosurgical instrument in a welding mode to stimulate regeneration of the injured nerve and to cause less prominent reactive changes in its segment motor center.

Association between cervical disc disease and lesions of multiple sclerosis

2021 ◽  
pp. 197140092098356
Author(s):  
Marwan Alkrenawi ◽  
Michael Osherov ◽  
Azaria Simonovich ◽  
Jonathan Droujin ◽  
Ron Milo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Disc ◽  
Cervical Disc Disease ◽  
Disc Disease ◽  
Group 4 ◽  
Demyelinating Lesions ◽  
Grade Ii ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background Cervical discopathy and demyelinating lesions often co-exist in patients with multiple sclerosis (MS). Our study examines the possible association between these two pathologies. Methods Medical records and cervical magnetic resonance imaging scans of MS patients with cervical discopathy who were seen at our MS clinic during 2018 were retrospectively reviewed. The severity of the disc disease was classified as grade I (no compression), grade II (compression of the dural sac) and grade III (cord compression). The spinal cord in each scan was divided into six segments corresponding to the intervertebral space of the spine (C1–C6). Each segment was defined as containing demyelinating lesion and disc pathology (group 1), demyelinating lesion without disc pathology (group 2), disc pathology without demyelinating lesion (group 3) and no demyelinating lesion or disc pathology (group 4). Fisher’s exact test was used to test the association between demyelinating lesions and disc pathology. Results Thirty-four MS patients with cervical discopathy were included in the study (26 females; average age 42.9 ± 13.7 years; average disease duration 8.4 ± 5.4 years). A total of 204 spinal cord segments were evaluated. Twenty-four segments were classified as group 1, 27 segments as group 2, 52 segments as group 3 and 101 segments as group 4. There was no association between demyelinating lesions and the grade of disc disease ( p = 0.1 for grade I, p = 0.3 for grade II and p = 1 for grade III disc disease). Conclusion Our study did not find any association between cervical disc disease and demyelinating spinal cord lesion.

scholarly journals Preemptive analgesic effect of lidocaine in a chronic neuropathic pain model

2009 ◽  
Vol 67 (4) ◽  
pp. 1088-1092 ◽  
Author(s):  
Leonardo M. Batista ◽  
Igor M. Batista ◽  
João P. Almeida ◽  
Carlos H. Carvalho ◽  
Samuel B. de Castro-Costa ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Control Group ◽  
Thermal Stimulus ◽  
Lidocaine Group ◽  
Local Infiltration ◽  
Neuropathic Pain Model ◽  
Group 3 ◽  
Group 2 ◽  
The Right

Preemptive analgesia inhibits the progression of pain caused by surgical lesions. To analyze the effect of lidocaine on postoperative pain relief, we performed compression of the right sciatic nerve in Wistar rats and observed the differences on behavior between the group that received lidocaine and the group that was not treated with the local anesthetics pre-operatively. Group 1 was not operated (control); group 2 underwent the sciatic nerve ligature without lidocaine; group 3, underwent surgery with previous local infiltration of lidocaine. Group 2 showed significantly longer scratching times with a peak on day 14 post-operative (p=0.0005) and reduction in the latency to both noxious (p=0.003) and non-noxious (p=0.004) thermal stimulus. Group 3 presented significantly shorter scratching times (p=0.004) and longer latency times when compared to Group 2. Preemptive use of lidocaine 2% can potentially reduce the postoperative neuropathic pain associated with sciatic nerve compression.

scholarly journals Dexmedetomidine to Help Nerve Regeneration in a Rat Sciatic Nerve Injury Model

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wook Jeong ◽  
Hsichiang Kung ◽  
Chia Chi Cheng ◽  
Changwoo Lim ◽  
Min Jung Jung ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Regeneration ◽  
Nerve Injury ◽  
Peripheral Nerve Regeneration ◽  
Sciatic Nerve Injury ◽  
Sprague Dawley ◽  
Neuroprotective Effects ◽  
Adrenoceptor Agonist ◽  
Group 3 ◽  
Group 2

Background. Several studies have shown that dexmedetomidine (DXM), a selective α2-adrenoceptor agonist, also has neuroprotective effects. However, its effect on impaired peripheral nerve regeneration has not been studied. Materials and Methods. Forty-five Sprague-Dawley rats were randomly assigned to three groups: group 1 (control SHAM), group 2 (sciatic nerve injury + normal saline), and group 3 (sciatic nerve injury + DXM). The rats of group 3 were subdivided into the following three groups: DXM 0.5, 6, and 20 μg·kg−1 (groups 3A, 3B, and 3C, resp.). The sciatic nerve injury was assessed for nerve regeneration at 2 and 6 weeks. Results. There were no differences between groups 2 and 3 in their sciatic functional index (SFI) values or histological findings at 2 weeks postinjury. However, SFI differences were statistically significant at 6 weeks postinjury in group 3. The gross findings with H&E staining showed that the number of axons was higher in group 3 than in group 2. There was no histological difference according to the DXM concentration. Conclusion. The coincidental functional and histological assessment results of this study suggest that DXM for 6 weeks positively affects damaged peripheral nerves.

Neuroprotection and functional recovery after application of the caspase-9 inhibitor z-LEHD-fmk in a rat model of traumatic spinal cord injury

2005 ◽  
Vol 2 (3) ◽  
pp. 327-334 ◽  
Author(s):  
Ahmet Çolak ◽  
Alper Karaoǧlan ◽  
Şeref Barut ◽  
Sibel Köktürk ◽  
Aysşenur Iǧdem Akyildiz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cell Death ◽  
Rat Model ◽  
Caspase 9 ◽  
Content Type ◽  
Cord Injury ◽  
Group 3 ◽  
Group 2 ◽  
Fine Print

Object. Apoptosis is considered one of the most significant mechanisms in the pathogenesis of neuronal damage after spinal cord injury (SCI). This form of cell death occurs via mediators known as caspases. The aim of this study was to evaluate the neuroprotective effect of the caspase-9 inhibitor, z-LEHD-fmk, in a rat model of spinal cord trauma. Methods. Fifty-four Wistar albino rats were studied in the following three groups of 18 animals each: sham-operated controls (Group 1); trauma-only controls (Group 2); and trauma combined with z-LEHD-fmk—treated animals (0.8 µM/kg; Group 3). Spinal cord injury was produced at the thoracic level by using the weight-drop technique. Responses to SCI and the efficacy of z-LEHD-fmk treatment were determined on the basis of terminal deoxynucleotidyl transferase—mediated deoxyuridine triphosphate nick—end labeling staining and light and electron microscopy findings in cord tissue at 24 hours and 7 days posttrauma. Six rats from each group were also assessed for functional recovery at 3 and 7 days after SCI. This was conducted using the inclined-plane technique and a modified version of the Tarlov motor grading scale. At 24 hours postinjury, light microscopic examination of Group 2 tissue samples showed hemorrhage, edema, necrosis, polymorphonuclear leukocyte infiltration, and vascular thrombi. Those obtained in Group 3 rats at this stage showed similar features. At 24 hours postinjury, the mean apoptotic cell count in Group 2 was significantly higher than that in Group 3 (90.25 ± 2.6 and 50.5 ± 1.9, respectively; p < 0.05). At 7 days postinjury, the corresponding mean apoptotic cell counts were 49 ± 2.1 and 17.7 ± 2.6, also a significant difference (p < 0.05). Electron microscopy findings confirmed the occurrence of programmed cell death in different cell types in the spinal cord and showed that z-LEHD-fmk treatment protected neurons, glia, myelin, axons, and intracellular organelles. Conclusions. Examination of the findings in this rat model of SCI revealed that apoptosis occurs not only in neurons and astrocytes but also in oligodendrocytes and microglia. Furthermore, immediate treatment with the caspase-9 inhibitor z-LEHD-fmk blocked apoptosis effectively and was associated with better functional outcome. More in-depth research of the role of programmed cell death in spinal cord trauma and further study of the ways in which caspases are involved in this process may lead to new strategies for treating SCI.

Neuroprotective effects of GYKI 52466 on experimental spinal cord injury in rats

2003 ◽  
Vol 98 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Ahmet Çolak ◽  
Osman Soy ◽  
Hafize Uzun ◽  
Özcan Aslan ◽  
Seref Barut ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neuroprotective Effects ◽  
Content Type ◽  
Gyki 52466 ◽  
Cord Injury ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Spinal Cord Injured ◽  
Fine Print

Object. The toxic effects of glutamate in the central nervous system are well known. This neurotoxicity occurs through metabotropic and ionotropic receptors, the latter group composed of N-methyl-d-aspartate, α-amino-3-hydroxy-5-methylisoxazole-4-proprionic acid (AMPA), and kainate receptors. The authors investigated the neuroprotective effects of GYKI 52466, a 2,3-benzodiazepine that is a selective and potent AMPA receptor antagonist, in a rat spinal cord trauma model. Methods. Sixty Wistar albino rats were studied in three groups of 20 animals each: sham-operated controls (Group 1); spinal cord—injured rats (Group 2); and spinal cord—injured plus GYKI 52466—treated rats (Group 3). In Groups 2 and 3, spinal cord injury (SCI) was induced at the thoracic level by applying an aneurysm clip to the cord for 1 minute. One minute after the clip was removed, the rats in Group 3 received an intraperitoneal injection of 15 mg/kg GYKI 52466. Responses to injury and treatment were evaluated based on biochemical parameters (lipid peroxidation and adenosine 5′-triphosphate [ATP] levels in tissue), and on light and transmission electron microscopy findings in cord tissue collected at different times post-SCI. Five rats from each group underwent assessment of functional recovery at 1, 3, and 5 days after SCI; evaluation was performed using the inclined-plane technique and Tarlov motor grading scale. The mean lipid peroxidation levels in Groups 1 and 2 were 21.73 ± 4.35 and 35.53 ± 2.99 nmol/g of wet tissue, respectively. The level in Group 3 was 27.98 ± 3.93 nmol/g of wet tissue, which was significantly lower than that in Group 2 (p < 0.01). The mean ATP levels in Groups 1 and 2 were 166.21 ± 25.57 and 41.72 ± 12.28 nmol/g of wet tissue, respectively. The ATP level in Group 3 was 85.82 ± 13.92 nmol/g of wet tissue, which was significantly higher than that in Group 2 (p < 0.01). Light microscopic examination of Group 2 tissues showed hemorrhage, necrosis, polymorphonuclear leukocyte infiltration, and vascular thrombi. In contrast, the examination of Group 3 tissues showed limited hemorrhage and no necrosis or vascular thrombi. The most prominent findings in Group 2 were hemorrhage and necrosis, whereas the most prominent findings in Group 3 were focal hemorrhage and leukocyte infiltration. Electron microscopy demonstrated that GYKI 52466 protected the neurons, myelin, axons, and intracellular organelles. The mean inclined-plane angles in Groups 1, 2, and 3 were 65°, 40 to 45°, and 55°, respectively. Motor scale results in all groups showed a similar trend. Conclusions. The findings in this rat model suggest that GYKI 52466 may provide significant therapeutic protection from secondary damage after acute SCI. This agent may be a viable alternative treatment for SCI.

scholarly journals Magnetic resonance imaging in the prone position and the diagnosis of tethered spinal cord

2018 ◽  
Vol 21 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Melissa M. Stamates ◽  
David M. Frim ◽  
Carina W. Yang ◽  
Gregory L. Katzman ◽  
Saad Ali
Keyword(s):  
Spinal Cord ◽  
Sensitivity And Specificity ◽  
Clinical Manifestations ◽  
Tethered Cord ◽  
Control Group ◽  
Motion Sensitivity ◽  
Canal Width ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

OBJECTIVETethered cord syndrome (TCS) is a neurosurgical disorder with varied clinical manifestations believed to result from vascular compromise due to stretch forces on the spinal cord. Conventional supine MRI findings may include a low-lying conus medullaris, thickened or fat-infiltrated filum terminale, or lipoma; however, imaging sensitivity and specificity for tethered cord can be low. The purpose of this study was to evaluate the utility of prone MRI in the diagnosis of tethered and retethered spinal cord.METHODSMedical records were reviewed in 41 patients who underwent surgical release of tethered cord and in whom preoperative prone MRI sequences were available. Patients were divided into Group 1 (new TCS diagnosis) and Group 2 (recurrent TCS after previous untethering). Absolute conus ventral motion and motion as a percentage of canal width between supine and prone positions was measured in these 2 groups via sagittal T2-weighted sequences; these groups were compared with 30 consecutive patients (Group 3) who were classified as the normal control group.RESULTSThe mean ventral motion was as follows: Group 1 (absolute: 0.5 ± 0.5 mm [range 0–2.4 mm]; canal percentage: 3.7% ± 3.9% [range 0%–16.3%]); Group 2 (absolute: 0.4 ± 0.7 mm [range 0–2.6 mm]; canal percentage: 2.2% ± 3.7% [range 0%–14.0%]); and Group 3 (absolute: 3.4 ± 1.3 mm [range 1.4–5.6 mm]; canal percentage: 22.0% ± 7.2% [range 10.5%–36.1%]). Whereas 38/41 surgically treated patients with TCS had diminished (< 10% canal width) ventral motion on preoperative MRI, 30/30 controls had > 10% canal width motion. Sensitivity and specificity were thereby calculated as 92.7% and 100%, respectively.CONCLUSIONSIn the present series, prone imaging is found to be a sensitive and specific tool, and the authors believe it may have a role as supportive evidence in the diagnosis of tethered and retethered spinal cord.

scholarly journals Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury

2021 ◽  
Vol 11 (3) ◽  
pp. 110-117
Author(s):  
O.S. Nekhlopochyn ◽  
V.V. Verbov ◽  
Ia.V. Tsymbaliuk ◽  
M.V. Vorodi ◽  
Ie.V. Cheshuk
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Neurological Disorders ◽  
Traumatic Injury ◽  
Neurological Dysfunction ◽  
Cord Injury ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. Neuropathic pain is one of the principal secondary complications of spinal cord injury. The biological role of neuropathic pain has not been established yet. This type of pain is formed directly in the area of the spinal cord injury; therefore, it can be assumed that its intensity may characterize both degenerative and reparative processes. The aim of this work is to assess the possible relationship between the intensity of neuropa­thic pain in patients with spinal cord injury at cervical subaxial spine and the dynamics of neurological disorder regression. Materials and methods. We have performed a retrospective analysis of patients referred to outpatient department of the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in the period from 2010 to 2020 after a surgical treatment of subaxial cervical spine traumatic injury. The extent of neurolo­gical disorders and the intensity of neuropathic pain were assessed within 5–7 and 11–13 months after surgery. Results. All 102 patients selected for analysis were divided into three groups depen­ding on the intensity of the registered pain sensations: 1) absence of constant pain sensations — 19.6 % of subjects, 2) moderate pain — 56.9 %, 3) severe neuropathic pain — 23.5 %. In the first group, the regression of neurological disorders was 3.5 (95% confidence interval (CI) 2.15–6.15), in the second — 25.0 (95% CI 24.14–29.58), in the third — 13.0 (95% CI 10.87–16.55). The differences are statistically significant (χ2 = 60.4, df = 2, p < 0.0001). In patients with severe neurological disorders, the dynamics of recovery did not correlate with the pain intensity. With ASIA B, the dynamics of group 1 was 8.5 (95% CI 10.56–27.56), of group 2 — 15.0 (95% CI 13.41–18.41), of group 3 — 10.5 (95% CI 7.45–14.89). With ASIA C functional class, the difference is even more pronounced: in group 1, the median was 8.0 (95% CI 0.83–20.83), in group 2 — 32.0 (95% CI 25.41–36.86), in group 3 — 15.5 (95% CI 10.27–27.4). With ASIA D, a similar trend was observed. Conclusions. The worst regression of neurological disorders is observed in patients without clinically significant pain, the best results of neurological dysfunction recovery are found in patients with mode rate neuropathic pain.

scholarly journals Impact of magnetic resonance imaging and urodynamic studies on the management of sacrococcygeal dimples

2017 ◽  
Vol 20 (3) ◽  
pp. 289-297 ◽  
Author(s):  
Goichiro Tamura ◽  
Nobuhito Morota ◽  
Satoshi Ihara
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Lumbosacral Region ◽  
Group 4 ◽  
Urodynamic Studies ◽  
Intraspinal Anomalies ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

OBJECTIVESacrococcygeal dimples in neonates and infants are of uncertain pathological import. Previously they were believed to be rarely associated with intraspinal anomalies. Recent studies using MRI, however, revealed that 6%–7% of pediatric cases of sacrococcygeal dimples were associated with anatomical tethered spinal cord (TSC). Because the prevalence of tethered cord syndrome is still unclear, there is no consensus among pediatric neurosurgeons on the management of children with sacrococcygeal dimples. The authors performed an analysis of MRI and urodynamic studies to validate their management strategy for pediatric cases of sacrococcygeal dimples.METHODSA total of 103 Japanese children (49 male and 54 female, median age 4 months, range 8 days–83 months) with sacrococcygeal dimples who were referred to the Division of Pediatric Neurosurgery between 2013 and 2015 were included in this study. The lumbosacral region of all the patients was investigated using MRI. Anatomical TSC was defined as a condition in which the caudal end of the conus medullaris is lower than the inferior border of the L2–3 intervertebral disc. Patients with minor spinal anomalies (e.g., anatomical TSC, filum lipoma, thickened filum, or filar cyst) underwent further urodynamic studies to ascertain the presence of neurogenic bladder (NGB). In this study, the presence of NGB without anatomical TSC but with other minor spinal anomalies was defined as “functional TSC.” The prevalence of anatomical and functional TSC was investigated. The association of the following cutaneous findings with spinal anomalies was also assessed: 1) depth of the dimple, 2) deviation of the gluteal fold, and 3) other skin abnormalities (e.g., discoloration, angioma, or abnormal hair).RESULTSThe children were classified into 4 groups: Group 1, patients with anatomical TSC; Group 2, patients with functional TSC; Group 3, patients without anatomical or functional TSC but with other minor spinal anomalies; and Group 4, patients with no spinal anomaly. There were 6 patients (5.8%) in Group 1, 8 patients (7.8%) in Group 2, 10 patients (9.7%) in Group 3, and 79 patients (76.7%) in Group 4. Twenty-four patients (23.3%; Groups 1, 2, and 3) showed MRI abnormalities, including filum lipoma (14 cases), filar cysts (5 cases), thickened filum (2 cases), and anatomical TSC without other spinal anomalies (3 cases). Untethering of the spinal cord was indicated for 14 patients (13.6%; Groups 1 and 2) with anatomical and functional TSCs. Preoperative NGB was found in 12 patients and improved postoperatively in 7 (58.3%). None of the associated lumbosacral skin findings predicted the presence of underlying spinal anomalies.CONCLUSIONSThe prevalence of tethered cord syndrome among children with sacrococcygeal dimples was, for the first time, revealed to be higher than previously thought. MRI and supplemental urodynamic studies may be indicated for children with sacrococcygeal dimples to identify patients with symptomatic TSC.

Civilian Gunshot Wounds to the Spinal Cord and Cauda Equina

Neurosurgery ◽  
1987 ◽  
Vol 20 (2) ◽  
pp. 281-285 ◽  
Author(s):  
Edward C. Benzel ◽  
Theresa A. Hadden ◽  
James Edward Coleman
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cauda Equina ◽  
Gunshot Wounds ◽  
Neurological Deficits ◽  
Sensory Loss ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Nonoperated Group

Abstract We evaluated 42 patients with neurological deficits after civilian gunshot wounds to the spine. Thirty-five of these patients (the study population presented here) received their initial and follow-up care at Louisiana State University Medical Center in Shreveport over a 4-year period. Each patient had incurred a single gunshot wound to the spinal cord or cauda equina with an accompanying neurological deficit. The patient population was divided into three groups. Group 1 patients had incurred a complete motor and sensory loss below the injury (20 patients (57%)). Group 2 patients had incurred incomplete spinal cord injuries (9 patients (26%)), whereas Group 3 patients had cauda equina injuries (6 patients (17%)). Myelography was performed for all Group 2 and 3 patients as well as Group 1 patients in whom the trajectory of the bullet did not explain a higher level of neurological injury (3 patients (15%)). A decompressive operation was performed in the patients whose myelography showed neural compression. Three patients in Group 1 (15%), 5 patients in Group 2 (56%), and 5 Group 3 patients (83%) underwent operation. All 3 Group 1 patients who underwent operation had some improvement of nerve root function postoperatively. All operated Group 2 and 3 patients had improvement of myelopathic or radicular function postoperatively. All began improving within several days of operation, implying a cause and effect relationship. None of the 17 nonoperated Group 1 patients improved neurologically, whereas 3 of the 4 nonoperated Group 2 patients improved. The single nonoperated Group 3 patient improved neurologically. It is concluded that patients with incomplete neurological injuries after civilian gunshot wounds to the spine can expect radicular or myelopathic improvement. Decompressive operation is indicated in selected cases with unexpected radicular injuries or incomplete myelopathic injuries with myelographic evidence of neural compression. A stepwise improvement in neurological function over that expected without operation should be realized in these cases.

Doppler ultrasound estimation of microbubbles in the arterial line during extracorporeal circulation

Perfusion ◽  
1990 ◽  
Vol 5 (1) ◽  
pp. 23-32 ◽  
Author(s):  
M. Sellman ◽  
T. Ivert ◽  
P. Stensved ◽  
M. Högberg ◽  
Bkh Semb
Keyword(s):  
Doppler Ultrasound ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Arterial Line ◽  
Membrane Oxygenator ◽  
Filter Group ◽  
S 100 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

A pulsed Doppler ultrasound system was used to analyse microbubble intensity and size in the arterial line during extracorporeal circulation (ECC). Thirty male patients, younger than 70 (range 28-69) years, underwent isolated coronary artery bypass grafting with either a bubble oxygenator (Shiley S-100) without (group 1, n = 10) or with (group 2, n = 10) a depth adsorption arterial line filter (Swank High Flow 6000); or with a membrane oxygenator (Shiley M-2000) without a filter (group 3, n = 10). Mean ECC and aortic crossclamp times were similar in the three groups. Measurements were performed during the initial five minutes of cooling, after 30-40 minutes of ECC and after 10 minutes of rewarming. Microbubble intensity and size did not differ significantly in the three groups at the different intervals. Significantly more and larger bubbles were detected in group 1 (15-150μm) compared to group 2 (< 35μm) (p< 0.001). In group 3 only a minimal number of small bubbles (< 65μm) were observed. An arterial line filter significantly reduced the number and size of microbubbles detected in the arterial line during ECC. A membrane oxygenator was associated with a further reduction of microbubble intensity.

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