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.
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.
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.
Conclusion: Despite significant differences in the design specifications, all oxygenators eliminated relevant GME volumes safely.
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001288083351808","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610320"}],"foaf:name":[{"@language":"en","@value":"Benstoem Carina"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351810","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610324"}],"foaf:name":[{"@language":"en","@value":"Andreas Goetzenich"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351814","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610322"}],"foaf:name":[{"@language":"en","@value":"Ralf Borchardt"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Enmodes GmbH, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351812","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610323"}],"foaf:name":[{"@language":"en","@value":"Christian Stoppe"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Intensive Care Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351813","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610326"}],"foaf:name":[{"@language":"en","@value":"Thomas Breuer"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Intensive Care Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351809","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610321"}],"foaf:name":[{"@language":"en","@value":"Christian Bleilevens"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001288083351811","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398610325"}],"foaf:name":[{"@language":"en","@value":"Ruedriger Autschbach"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13411098"},{"@type":"EISSN","@value":"21861005"}],"prism:publicationName":[{"@language":"en","@value":"Annals of Thoracic and Cardiovascular Surgery"},{"@language":"en","@value":"ATCS"},{"@language":"en","@value":"Ann Thorac Cardiovasc Surg"}],"dc:publisher":[{"@language":"en","@value":"The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery"},{"@language":"ja","@value":"Annals of Thoracic and Cardiovascular Surgery 編集委員会"}],"prism:publicationDate":"2018","prism:volume":"24","prism:number":"5","prism:startingPage":"230","prism:endingPage":"237"},"reviewed":"false","url":[{"@id":"https://www.jstage.jst.go.jp/article/atcs/24/5/24_oa.18-00019/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2019187996"}],"availableAt":"2018","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=gaseous%20microemboli","dc:title":"gaseous microemboli"},{"@id":"https://cir.nii.ac.jp/all?q=oxygenator","dc:title":"oxygenator"},{"@id":"https://cir.nii.ac.jp/all?q=extracorporeal%20circulation","dc:title":"extracorporeal circulation"},{"@id":"https://cir.nii.ac.jp/all?q=perioperative%20outcome","dc:title":"perioperative outcome"},{"@id":"https://cir.nii.ac.jp/all?q=thoracic%20surgery","dc:title":"thoracic surgery"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360011144912285184","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Evaluation of Capiox RX25 and Quadrox-i Adult Hollow Fiber Membrane Oxygenators in a Simulated Cardiopulmonary Bypass Circuit"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016870442891392","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Hemolysis in Cardiac Surgery Patients Undergoing Cardiopulmonary Bypass: A Review in Search of a Treatment Algorithm"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292618603529344","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Clinical evaluation of contemporary oxygenators"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292618849298688","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Gas Embolism"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292619115303424","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Evaluation of Capiox FX05 Oxygenator With an Integrated Arterial Filter on Trapping Gaseous Microemboli and Pressure Drop With Open and Closed Purge Line"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298345004826496","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Can the Oxygenator Screen Filter Reduce Gaseous Microemboli?"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574095589956480","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Stroke during coronary bypass surgery: principal role of cerebral macroemboli"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855569237355264","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Neuropsychologic impairment after coronary bypass surgery: Effect of gaseous microemboli during perfusionist interventions"}]},{"@id":"https://cir.nii.ac.jp/crid/1360861295469198848","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"In Vitro Evaluation of the Air Separation Ability of Four Cardiovascular Manufacturer Extracorporeal Circuit Designs"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137045662813952","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Stroke Risk After Coronary Artery Bypass Graft Surgery and Extent of Cerebral Artery Atherosclerosis"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418520430109952","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Size Distribution of Air Bubbles Entering the Brain during Cardiac Surgery"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418520971737984","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Significantly reduced adsorption and activation of blood components in a membrane oxygenator system coated with crosslinkable zwitterionic copolymer"}]},{"@id":"https://cir.nii.ac.jp/crid/1361981469463344512","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Timing of Stroke After Cardiopulmonary Bypass Determines Mortality"}]},{"@id":"https://cir.nii.ac.jp/crid/1361981471225817856","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Microbubbles"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825893293873280","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Gaseous microemboli in cardiac surgery with cardiopulmonary bypass: the use of veno-arterial shunt as a preventive method"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825894638899712","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Clinical evaluation of the air-handling properties of contemporary oxygenators with integrated arterial filter"}]},{"@id":"https://cir.nii.ac.jp/crid/1363107370890247936","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Risk Factors For Recurrent Stroke After Coronary Artery Bypass Grafting"}]},{"@id":"https://cir.nii.ac.jp/crid/1363388843273117568","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A clinical comparison of bubble elimination in Quadrox and Polystan oxygenators"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2005499822"},{"@type":"CROSSREF","@value":"10.5761/atcs.oa.18-00019"},{"@type":"PUBMED","@value":"29998925"},{"@type":"CIA","@value":"130007499416"}]}