Retrospective Analysis of Air Handling by Contemporary Oxygenators in the Setting of Cardiac Surgery
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- Benstoem Carina
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
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- Christian Bleilevens
- Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
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- Ralf Borchardt
- Enmodes GmbH, Aachen, Germany
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- Christian Stoppe
- Department of Intensive Care Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
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- Andreas Goetzenich
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
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- Ruedriger Autschbach
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
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- Thomas Breuer
- Department of Intensive Care Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
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説明
<p>Purpose: Cardiac surgery with the use of extracorporeal circulation is associated with a significant risk for gaseous microemboli (GME) despite excellent surgical techniques and highest operative standards. GME are associated with postoperative neurocognitive dysfunction and negative clinical outcome. This study determines whether oxygenator design has influence on perioperative outcome after cardiac surgery.</p><p>Methods: Three different oxygenator models with integrated arterial filter (HiliteAF 7000, Fusion Affinity, and Synthesis) were retrospectively evaluated in 55 patients undergoing elective cardiac surgery with the use of extracorporeal circulation. The two-channel ultrasound bubble counter BCC200 was used to detect GME in real time.</p><p>Results: All three oxygenators differ in terms of structural specifications and have different rates of number and volume GME reduction. The Fusion Affinity had the lowest arterial GME volume (1.81 µL ± 0.23 µL), which was statistically significant compared to the Synthesis (3.37 µL ± 0.71 µL, p = 0.014). However, the Synthesis had lower absolute numbers at the venous GME count (31771 µL ± 6579 µL) versus the Fusion Affinity (49304 µL ± 8196 µL). However, with regard to clinical outcome after cardiac surgery (duration of invasive and non-invasive mechanical ventilation, incidence of delirium, stroke, acute renal failure, or new myocardial infarction), we found no differences between groups.</p><p>Conclusion: Despite significant differences in the design specifications, all oxygenators eliminated relevant GME volumes safely.</p>
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 24 (5), 230-237, 2018
Annals of Thoracic and Cardiovascular Surgery 編集委員会