Doppler Ultrasound Estimation of Bubble Removal by Various Arterial Line Filters During Extracorporeal Circulation

1982 ◽  
Vol 16 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Bjarne K. H. Semb ◽  
Tore Pedersen ◽  
Kjell Hatteland ◽  
Liv Storstein ◽  
Per Lilleaasen
Keyword(s):  
Doppler Ultrasound ◽  
Extracorporeal Circulation ◽  
Arterial Line ◽  
Bubble Removal

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.

Abstract 128: Time for a Change: Use of Doppler Ultrasound for Pulse Checks in Cardiac Arrest Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Allison Cohen ◽  
Timmy Li ◽  
Lance B Becker ◽  
Daniel Rolston ◽  
Mathew Nelson ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sensitivity And Specificity ◽  
Doppler Ultrasound ◽  
Life Support ◽  
Arterial Line ◽  
Pulse Detection ◽  
Pulse Palpation ◽  
Manual Palpation ◽  
Sensitivity Specificity ◽  
Pulse Check

Introduction: During cardiopulmonary resuscitation, the presence or absence of a pulse is critical in guiding the management of cardiac arrest (CA) patients. Despite the importance placed on palpating a pulse, several reports have shown that providers lack accuracy in determining it the presence via manual palpation. The purpose of this study is to assess the sensitivity, specificity, and accuracy of manual femoral pulse detection as compared to Doppler ultrasound pulse detection in CA patients. Hypothesis: We hypothesize that a Doppler ultrasound obtained pulse will be more accurate than manual palpation for detecting an arterial pulse in patients in CA. Methods: This is a prospective observational study of non-traumatic CA patients that occurred at North Shore University Hospital. During a pulse check, the presence of both a femoral Doppler waveform and manual femoral pulse were recorded simultaneously. These values were compared to the arterial line waveform, which served as the gold standard. During each pulse check, the presence or absence of a pulse was documented, as well as the arterial line measurement. We calculated the sensitivity, specificity, and accuracy of manual palpation and Doppler ultrasound determination of the presence of a pulse. Results: We enrolled a total of 23 patients. The sensitivity of Doppler ultrasound detection of a pulse was 0.82 (95% CI: 0.72, 0.93) with a specificity of 1.00 (95% CI: 1.00, 1.00), and accuracy of 0.88 (95% CI: 0.78, 0.94). The sensitivity and specificity of manual palpation of a pulse was 0.27 (95% CI: 0.15, 0.40) and 0.90 (95% CI: 0.78, 1.00), respectively, with an accuracy of 0.46 (95% CI: 0.34, 0.58). Conclusion: Determining the presence of a pulse in the management of cardiac arrest patients is a critical step in the Advanced Cardiovascular Life Support algorithm. Our preliminary data suggests that Doppler ultrasound has a higher sensitivity and specificity for detecting a pulse in CA patients and highlights the inaccuracy of manual pulse palpation. These preliminary results could lead to a change in the practice of pulse checks, to favor the use of Doppler ultrasound detection. Further data is needed to determine what blood pressure readings correspond to a perfusable rhythm.

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.

Comparison of conventional extracorporeal circulation and minimal extracorporeal circulation with respect to microbubbles and microembolic signals

Perfusion ◽  
2005 ◽  
Vol 20 (6) ◽  
pp. 329-333 ◽  
Author(s):  
M Perthel ◽  
S Kseibi ◽  
F Sagebiel ◽  
A Alken ◽  
J Laas
Keyword(s):  
Extracorporeal Circulation ◽  
Left Middle Cerebral Artery ◽  
Arterial Line ◽  
Air Trapping ◽  
Air Contamination ◽  
Doppler System ◽  
Priming Volume ◽  
Venous Cannula ◽  
The Right ◽  
Left Middle

The intention of minimal extracorporeal circulation (MECC) is to reduce priming volume and minimize contact of blood with polymers and air in a closed system. In contrast to conventional extracorporeal circulation (ECC), a venous reservoir is missing. Thus, air trapping is limited and avoidance of bubble embolism is a major concern. This study investigates microbubbles (MBB) number and size in the venous and arterial lines of ECC and MECC compared to the number of microembolic signals (MES) in the right and left middle cerebral artery (MCA). Twenty patients undergoing coronary surgery were operated either with conventional ECC (cardiotomy reservoir, Rotaflow pump, Quadrox oxygenator, Quart filter) or MECC (Quart filter, Rotaflow pump, Quadrox oxygenator). Number and size of MBB were monitored in the venous and arterial lines with an ultrasound Doppler system. MES in right and left MCAs were measured by transcranial Doppler (TCD) monitoring. Patients undergoing MECC had additional sealing of the venous cannula by a ligature at the site of its insertion into the right atrium. There were no significant differences between groups with respect to age, X-clamping, bypass time and number of distal anastomoses. The number of MES and MBB in the arterial line was comparable between the groups. On the venous side, MECC-perfusion shows a significantly lower number of MBB. This could be explained with the additional sealing of the venous cannula. Furthermore, our data indicate that the MBB-volume reaching the pump will also appear in the arterial outflow and into the patient’s MCA. For this reason, the avoidance of air contamination is a major concern for surgeons, anaesthesiologists and perfusionists.

Haematological effects of a depth absorption arterial line filter during extracorporeal circulation

Perfusion ◽  
1989 ◽  
Vol 4 (4) ◽  
pp. 255-264 ◽  
Author(s):  
M. Sellman ◽  
T. Ivert ◽  
M. Blombäck ◽  
Bkh Semb
Keyword(s):  
Extracorporeal Circulation ◽  
Arterial Line

Blockage of extracorporeal circulation during emergency surgery for fulminant infective endocarditis

Perfusion ◽  
2020 ◽  
pp. 026765912097885
Author(s):  
Edward Pietrzyk ◽  
Anna Polewczyk ◽  
Katarzyna Ciuraszkiewicz
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Antibiotic Therapy ◽  
Extracorporeal Circulation ◽  
Arterial Line ◽  
History Of ◽  
Immediate Surgery ◽  
Made In

A 37-years-old man with a history of alcohol abuse and pancreatitis, presented to the emergency department with a 1-week history of progressively worsening dyspnoea with a fever up to 39°C. Echocardiography revealed bicuspid aortic valve with additional mobile structure and perforation of leaflet with acute aortic regurgitation. Due to rapidly deteriorating condition of the patient, a decision about immediate surgery was made. In the operating room, cardiac arrest in the asystole mechanism occurred. Extracorporeal circulation was turned on during direct heart massage. After opening of the aorta, the circulation was blocked by total clogging of the arterial line filter by fibrine deposits. The oxygenator was replaced which resulted a break in extracorporeal circulation lasting about 10 min. Patients survived surgery and was discharged after 6 week antibiotic therapy.

Experimental study of total body washout employing extracorporeal circulation and hypothermia

1974 ◽  
Vol 126 (2) ◽  
pp. 243-248
Author(s):  
A WAKABAYASHI ◽  
T KUBO ◽  
K CHARNEY ◽  
Y NAKAMURA ◽  
J CONNOLLY
Keyword(s):  
Experimental Study ◽  
Extracorporeal Circulation ◽  
Total Body
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