Evaluation of air handling in a new generation neonatal oxygenator with integral arterial filter

Abstract

Prime volume of the cardiopulmonary bypass circuit may lead to significant hemodilution and the potential need for blood products for all patients, but may be more critical in the pediatric and, specifically, the neonatal patient. We report on the first use of the Terumo^® CAPIOX^® FX05 (Baby-FX™) oxygenator with integral arterial filter, prime volume 43 ml, evaluating performance and air-handling of six Baby-FX™ versus thirteen Baby-RX™ oxygenators. The Terumo Baby-FX™ primes and performs as easily as the Baby-RX™ series. A significant prime component in the neonatal CPB circuit can be the arterial line filter (ALF). Removal of the ALF may lead to significant reduction in prime volume, decreased exposure to foreign surfaces with subsequent reduction in inflammation, and potential elimination or reduction in blood product exposures.

Keywords

gaseous microemboli arterial line filter oxygenator EDAC cardiopulmonary bypass

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References

1 Butler DB . Gaseous micro emboli: concepts and considerations. J Extra Corpor Technol 1983; 15(6): 148–155.

2 Lynch JE Riley JB . Microemboli detection on extracorporeal bypass circuits. Perfusion 2008; 23(1): 23–32.

3 Merkle F Bottcher W Hetzer R . Prebypass filtration of cardiopulmonary bypass circuits: an outdated technique? Perfusion 2003; 18(Suppl 1): 81–88.

4 Myers GJ . Preventing gaseous microemboli during blood sampling and drug administration: an in vitro investigation. J Extra Corpor Technol 2007; 39(3): 192–198.

5 Norman MJ Sistino JJ Acsell JR . The effectiveness of low-prime cardiopulmonary bypass circuits at removing gaseous emboli. J Extra Corpor Technol 2004; 36(4): 336–342.

6 Schreiner RS Rider AR Myers JW . Microemboli detection and classification by innovative ultrasound technology during simulated neonatal cardiopulmonary bypass at different flow rates, perfusion modes, and perfusate temperatures. Asaio J 2008; 54(3): 316–324.

7 Undar A Ji B Kunselman AR Myers JL . Detection and classification of gaseous microemboli during pulsatile and nonpulsatile perfusion in a simulated neonatal CPB model. Asaio J 2007; 53(6): 725–729.

8 Wang S Win KN Kunselman AR Woitas K Myers JL Undar A . The capability of trapping gaseous microemboli of two pediatric arterial filters with pulsatile and nonpulsatile flow in a simulated infant CPB model. Asaio J 2008; 54(5): 519–522.

9 Win KN Wang S Undar A . Microemboli generation, detection and characterization during CPB procedures in neonates, infants, and small children. Asaio J 2008; 54(5): 486–490.

10.

10 Merkle F Boettcher W Schulz F . Reduction of microemboli count in the priming fluid of cardiopulmonary bypass circuits. J Extra Corpor Technol 2003; 35(2): 133–138.

11.

11 Riley JB . Arterial line filters ranked for gaseous micro-emboli separation performance: an in vitro study. J Extra Corpor Technol 2008; 40(1): 21–26.

12.

12 Groom RC Froebe S Martin J . Update on pediatric perfusion practice in North America: 2005 survey. J Extra Corpor Technol 2005; 37(4): 343–350.

13.

13 Elliott M . Current paediatric perfusion practice in the UK. Perfusion 1993; (8): 7–25.

14.

14 Diegeler A Hirsch R Schneider F . Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. Ann Thorac Surg 2000; 69(4): 1162–1166.