Kinetics of 51Cr-Labeled Thrombocytes During Cardiopulmonary Bypass Circulation

1975 ◽  
Author(s):  
J. M. Michiels ◽  
J. Lindemans ◽  
D. S. de Jong ◽  
E. Krenning-Douma
Keyword(s):  
Cardiopulmonary Bypass ◽  
Platelet Rich Plasma ◽  
Arterial Line ◽  
Extracorporeal Circuit ◽  
External Monitoring ◽  
Heart Lung Machine ◽  
Filter Area ◽  
Kinetics Of ◽  
Lung Machine

The decrease in number of circulating platelets during the use of cardiopulmonary bypass (C. P. B.) in cardiac surgery had been found to be larger than could be explained on the basis of hemoclilutions in the heart-lung machine (H. L. M.). It is demonstrated in seven experiments, that the radioactivity of 51Cr-labeled donor platelets, which had been transfused 24 hours prior to the operation, decrease at the same rate as the total number of platelets in the patient’s blood. It is known that many platelets adhere to the filters in the extracorporeal circuit, especially to the terminal filter in the arterial line. External monitoring over the filter area revealed that adherence of radioactive thrombocytes reached a maximum within a few minutes after complete mixing of the patient’s blood with the blood-Hemaccel® mixture in the H. L. M., and that the radioactivity remained fairly constant during the ensuing C. P. B. The disappearance rate of platelets appeared to be closely correlated with the accumulation of 51Cr-radioactivity on the filters of the H. L. M. During cardiopulmonary bypass circulation non-platelet bound radioactivity increased gradually, suggesting release of 51Cr from platelets. Irreversible A. D. P. aggregation in vitro of 51Cr-labeled platelets did not lead to release of radioactivity, but it was found after coagulation of recalcified platelet rich plasma. The results of this study indicate that during cardiopulmonary bypass circulation, platelets aggregate and adhere to the filters in the first minutes, and that subsequently platelets are damaged and/or consumed.

An Automatically Regulated Low Prime Heart-Lung Machine for Infants: A Rabbit Model

Perfusion ◽  
1987 ◽  
Vol 2 (2) ◽  
pp. 109-113
Author(s):  
Erik Wabeke ◽  
Piet H Mook ◽  
Jan M Elstrodt ◽  
Charles RH Wildevuur
Keyword(s):  
Cardiopulmonary Bypass ◽  
Negative Pressure ◽  
Rabbit Model ◽  
Gravity Drainage ◽  
Extracorporeal Circuit ◽  
Donor Blood ◽  
Minimal Volume ◽  
Priming Volume ◽  
Heart Lung Machine ◽  
Lung Machine

A new compact heart-lung machine for paediatric use was designed. The total volume of this system of only 90ml allows for priming without the use of donor blood. The priming volume could be kept small mainly by replacing gravity drainage with drainage by a negative pressure in the venous reservoir. To avoid volume shifts between the extracorporeal circuit and the infant's circulation and to safely operate this minimal volume circuit, the heart-lung machine was automatically controlled. In this study we show that the miniaturized system functioned reliably under various conditions during cardiopulmonary bypass in rabbits.

scholarly journals Application of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary bypass

2012 ◽  
Vol 93 (2) ◽  
pp. 354-356
Author(s):  
R K Dzhordzhikiya ◽  
I M Rakhimullin ◽  
R R Khamzin
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fresh Frozen Plasma ◽  
Cell Saver ◽  
Intraoperative Bleeding ◽  
Heart Lung Machine ◽  
Mass Transfusion ◽  
Fresh Frozen ◽  
Hospital Days ◽  
Lung Machine ◽  
Frozen Plasma

Aim. To evaluate the effectiveness of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary circulation. Methods. Analysis of perfusion protocols and transfusion cards of cardiosurgical patients operated using cardiopulmonary bypass during the period 2010-2011. Two groups of patients were identified: the first group - with the application of blood salvaging technologies (906 patients), the second group - without the application of this technique (122 patients). Blood from the operative wound was collected during the operation, processed, filtered through the «Cell-saver» machine from «Fresenius» company and was then re-introduced into the patient’s bloodstream. After completion of cardiopulmonary bypass the blood remaining in the circuit of the cell-saver machine and blood that was discharged through the drainage tubes was returned to the patient after being processed. Results. In the first group at the end of the operation 314.6±28.6 ml of washed red blood cells were returned to the patient from the heart-lung machine, while during the first postoperative day, the amount of the returned autologous erythrocytes from the drainage tubes was 72.8±12.5 ml. In this group, only 45 (4.9%) patients required donor erythrocyte mass transfusion, its volume per patient amounted to 172.3±31.8 ml. In the first group 182 (20.1%) patients required transfusion of fresh frozen plasma with the aim of achieving hemostasis, its volume amounted to 425±51.3 ml. In the second group 51 (41.8%) patients received erythrocyte mass transfusion in the volume of 346.7±31.1 ml, and 86 (70.5%) - received fresh frozen plasma in the amount of 568.7±41.2 ml. Hemoglobin content and hematocrit at the end of the operation and on the first postoperative day were significantly higher in the first group compared to the second group (p 0.01). These changes were associated with both intraoperative bleeding and with the loss of blood through the drainage tubes on the first postoperative day in the second group of patients. Compensation for these losses required transfusion of blood components significantly more frequently (p 0.001) and in larger volumes (p 0.01) than in the first group. Conclusion. Blood salvaging technologies using the «Cell-saver» machine during cardiac surgery under cardiopulmonary bypass significantly reduce blood loss, reduce the number of postoperative hospital days and complications, and are less expensive.

scholarly journals Synthetic Material Abdominal Swabs Reduce Activation of Platelets and Leukocytes Compared to Cotton Materials

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1023
Author(s):  
Katharina Gerling ◽  
Lisa Maria Herrmann ◽  
Christoph Salewski ◽  
Melanie Wolf ◽  
Pia Müllerbader ◽  
...  
Keyword(s):  
Patient Group ◽  
Plasma Proteins ◽  
Natural Material ◽  
Synthetic Materials ◽  
Heart Lung Machine ◽  
Vulnerable Patient ◽  
Vulnerable Patient Group ◽  
First Time ◽  
Lung Machine

During surgical procedures, cotton abdominal swabs with their high absorptive capacity and malleability are used to retain organs and absorb blood or other body fluids. Such properties of the natural material cotton are advantageous for most operations, but in cardiopulmonary bypass (CPB) surgery, a high blood volume can accumulate in the thoracic cavity that is quickly retransfused via the heart–lung machine (HLM). This common practice is supposed to be safe due to the high anticoagulation. However, in vitro analyses showed that blood cells and plasma proteins were activated despite a high anticoagulation, which can propagate especially an inflammatory response in the patient. Thus, we investigated patients’ blood during CPB surgery for inflammatory and coagulation-associated activation after contact to the HLM and either cotton or synthetic abdominal swabs. Contact with cotton significantly increased thrombocyte and neutrophil activation measured as β-thromboglobulin and PMN-elastase secretion, respectively, compared to synthetic abdominal swabs. Both inflammatory cytokines, interleukin (IL) 1β and IL6, were also significantly increased in the cotton over the synthetic patient group, while SDF-1α was significantly lower in the synthetic group. Our data show for the first time that cotton materials can activate platelets and leukocytes despite a high anticoagulation and that this activation is lower with synthetic materials. This additional activation due to the material on top of the activation exerted by the tissue contact that blood is exposed to during CPB surgery can propagate further reactions in patients after surgery, which poses a risk for this already vulnerable patient group.

Continuous perfusion without hemodilution in neonates—the experience at the Marie Lannelongue Hospital

1993 ◽  
Vol 3 (4) ◽  
pp. 340-346 ◽  
Author(s):  
François Lacour-Gayet ◽  
François Nicolas ◽  
José Coil ◽  
Jean Pierre Daniel ◽  
Michel Weiss ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Heart Lung Machine ◽  
Lung Machine ◽  
Continuous Perfusion

Cardiopulmonary bypass in neonates is markedly different from the procedure used in children above 10 kg and in adults. There are two major reasons for this—first, the mismatch between the volume of the heart-lung machine circuit and that of the blood in the patient and second, the immaturity of tissues in the first three months of life.

Air removal capacity of two different minimal invasive ECC systems: an in vitro comparison

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 561-567
Author(s):  
Marco C Stehouwer ◽  
Roel de Vroege
Keyword(s):  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Extracorporeal Circulation ◽  
In Vitro Study ◽  
Vitro Study ◽  
Circulation System ◽  
Arterial Line ◽  
Minimized Extracorporeal Circulation ◽  
Air Removal

Minimally invasive extracorporeal circulation systems are developed to decrease the deleterious effects of cardiopulmonary bypass. For instance, prime volume and foreign surface area are decreased in these systems. However, because of the lack of a venous reservoir in minimized systems, air handling properties of these minimally invasive extracorporeal circulation systems may be decreased as compared to conventional cardiopulmonary bypass systems. The aim of this in vitro study is to compare the air handling properties of two complete minimized cardiopulmonary bypass systems of two manufacturers, of which one system is provided with the air purge control. In an in vitro study, two minimally invasive extracorporeal circulation systems, Inspire Min.I manufactured by Sorin Group Italia, Mirandola, Italy (LivaNova, London, United Kingdom) and minimized extracorporeal circulation manufactured by Maquet, Rastatt, Germany (Getinge, Germany), were challenged with two types of air challenges; a bolus air challenge and a gaseous microemboli challenge. The air removal characteristics of the venous bubble traps and of the complete minimally invasive extracorporeal circulation systems were assessed by measuring the gaseous microemboli volume and number downstream of the venous bubble traps in the arterial line with a bubble counter. No significant differences were observed in air reduction between the venous bubble traps of Getinge (venous bubble traps) and LivaNova (Inspire venous bubble traps 8 in conjunction with the air purge control). Similarly, no significant differences were observed in volume and number of gaseous microemboli in the arterial line of both complete minimally invasive extracorporeal circulation systems. However, the gaseous microemboli load of the Inspire Min.I system was marginally lower after both the bolus air and the gaseous microemboli challenges. Both minimally invasive extracorporeal circulation systems assessed in this study, the LivaNova Inspire Min.I and the Getinge minimized extracorporeal circulation, showed comparable air removal properties, after both bolus and gaseous microemboli air challenges. Besides, air purge control automatic air removal system provided with the LivaNova Inspire Min.I. system may enhance patient’s safety with the use of a minimally invasive extracorporeal circulation system. We consider both systems equally safe for clinical use.

Design of a Physiologic Pulsatile Flow Cardiopulmonary Bypass System for Neonates and Infants

1996 ◽  
Vol 19 (3) ◽  
pp. 170-176 ◽  
Author(s):  
A. Ündar ◽  
T.M. Runge ◽  
O.L. Miller ◽  
M.C. Felger ◽  
R. Lansing ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulsatile Flow ◽  
Surgical Techniques ◽  
Primary Objective ◽  
Extracorporeal Circuit ◽  
Mean Pressure ◽  
Extracorporeal Circuits ◽  
Aortic Cannula

Cardiopulmonary bypass surgical techniques that allow a surgeon to operate on the infant's heart use an extracorporeal circuit consisting of a pump, oxygenator, arterial and venous reservoirs, cannulae, an arterial filter, and tubing. The extracorporeal technique currently used in infants and neonates is sometimes associated with neurologic damage. We are developing a modified cardiopulmonary bypass system for neonates that has been tested in vitro and in one animal in vivo. Unlike other extracorporeal circuits which use steady flow, this system utilizes pulsatile flow, a low prime volume (500ml) and a closed circuit. During in vitro experiments, the pseudo patient's mean arterial pressure was kept constant at 40 mmHg and the extracorporeal circuit pressure did not exceed a mean pressure of 200 mmHg. In our single in vivo experiment, the primary objective was to determine whether physiologic pulsatility with a 10F (3.3 mm) aortic cannula could be achieved. The results suggest that this is possible.

In vitro study of hormone degradation by heart-lung machine with bubble oxygenator

Resuscitation ◽  
1984 ◽  
Vol 11 (1-2) ◽  
pp. 69-77 ◽  
Author(s):  
J. Malatinský ◽  
M. Vigaš ◽  
D. Vršanský ◽  
R. Kvetňanský ◽  
Jana Jurčovičová ◽  
...  
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Bubble Oxygenator ◽  
Heart Lung Machine ◽  
Lung Machine

Use of a large bore syringe creates significantly fewer high intensity transient signals (HITS) into a cardiopulmonary bypass system than a small bore syringe

Perfusion ◽  
2006 ◽  
Vol 21 (1) ◽  
pp. 67-71 ◽  
Author(s):  
James L Rudolph ◽  
Daniel Tilahun ◽  
Patrick R Treanor ◽  
Val E Pochay ◽  
Meetali A Mahendrakar ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
High Intensity ◽  
Injection Rate ◽  
The Other ◽  
Arterial Line ◽  
Injection Time ◽  
Transient Signals ◽  
Relationship Of ◽  
The Relationship

Introduction: High intensity transient signals (HITS) have been reported to occur following perfusionist intervention during cardiac surgery. This study investigates the relationship of the syringe bore, injection rate, and HITS created. Methods: Syringes (10 mL) with a male luer-lock connection (Large Bore) and Abboject ‘jet syringes’ with a 20 GA needle and male luer-lock connector (Small Bore) were filled with 10 mL of 0.9 N saline. A perfusionist was randomly assigned a set of four similar syringes followed by the other syringe bore. Each of the four syringes was injected into an in vitro saline-primed cardiopulmonary bypass (CPB) system over 5, 10, 15, or 20 sec. Sixteen randomizations of small and large bore syringes were completed at the four injection times (128 injections). HITS in the CPB arterial line were detected with transcranial Doppler (TCD) probes, were recorded for the 2 min following the injection, and were counted independently off-line by two reviewers. Results: The use of a large bore syringe compared to a small bore syringe created significantly fewer HITS (29±6 versus 145±17 [mean±SEM], p <0.001) introduced into the CPB arterial line. Injection over a longer time produced significantly fewer HITS than shorter injection times ( p <0.001). Conclusion: Significantly fewer HITS are introduced into the CPB system by using standard syringes and slower injection time.

An in vitro comparison of the ability of three commonly used pediatric cardiopulmonary bypass circuits to filter gaseous microemboli

Perfusion ◽  
2010 ◽  
Vol 25 (4) ◽  
pp. 255-263 ◽  
Author(s):  
Richard W Melchior ◽  
Tami Rosenthal ◽  
Andrew C Glatz
Keyword(s):  
Cardiopulmonary Bypass ◽  
In Vitro Model ◽  
The Other ◽  
Arterial Line ◽  
Independent Variables ◽  
Absolute Flow ◽  
In Vitro Investigation ◽  
Vitro Model ◽  
Different Levels

Background: The purpose of this study was to compare the ability of three commonly used pediatric cardiopulmonary bypass (CPB) circuits to filter gaseous microemboli (GME) in an in vitro model. Methods: Devices were tested at different levels of two specific independent variables: volume of air injected (1, 3, 5ml) and percentage of each oxygenator’s rated flow (50%, 75%, 100%, 125%). The air-handling ability of each CPB circuit was determined by the Emboli Detection and Classification Quantifier (Luna Innovations Inc., Roanoke,VA). Results: At all tested conditions, the FX-05 allowed a higher percentage of GME when compared to either one or both of the other two CPB circuits. When comparing oxygenators at similar absolute flow rates, the KIDS D100/D130 CPB circuit performed worse compared to the other two CPB circuits. C onclusions: The combination of the Baby RX-05 oxygenator and Capiox AF02 arterial line filter provides the highest level of protection from air emboli in an in vitro investigation.

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