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Ann Thorac Cardiovasc Surg ; 24(5): 230-237, 2018 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-29998925

RESUMO

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.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Embolia Aérea/prevenção & controle , Circulação Extracorpórea/instrumentação , Oxigenadores , Injúria Renal Aguda/etiologia , Idoso , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Delírio/etiologia , Embolia Aérea/diagnóstico por imagem , Embolia Aérea/etiologia , Desenho de Equipamento , Circulação Extracorpórea/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia
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