Investigation of air bubble properties: relevance to prevention of coronary air embolism during cardiac surgery

2021 ◽  
Author(s):  
Kazuki Kihara ◽  
Kazumasa Orihashi
Keyword(s):  
Cardiac Surgery ◽  
Air Embolism ◽  
Air Bubble ◽  
Bubble Properties

scholarly journals THE EFFECTS OF AIR EMBOLISM IN THE SYSTEMIC CIRCULATION AND ITS PREVENTION DURING OPEN CARDIAC SURGERY

1957 ◽  
Vol 34 (4) ◽  
pp. 548-552 ◽  
Author(s):  
Robert B. Benjamin ◽  
Charles E. Turbak ◽  
F. John Lewis
Keyword(s):  
Cardiac Surgery ◽  
Air Embolism ◽  
Systemic Circulation

scholarly journals Effect of cannulation site on emboli travel during cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mira Puthettu ◽  
Stijn Vandenberghe ◽  
Stefanos Demertzis
Keyword(s):  
Cardiac Surgery ◽  
In Vitro Study ◽  
Blood Stream ◽  
Air Bubbles ◽  
Arterial Tree ◽  
Air Bubble ◽  
Cannulation Site ◽  
The Brain

Abstract Background During cardiac surgery, micro-air emboli regularly enter the blood stream and can cause cognitive impairment or stroke. It is not clearly understood whether the most threatening air emboli are generated by the heart-lung machine (HLM) or by the blood-air contact when opening the heart. We performed an in vitro study to assess, for the two sources, air emboli distribution in the arterial tree, especially in the brain region, during cardiac surgery with different cannulation sites. Methods A model of the arterial tree was 3D printed and included in a hydraulic circuit, divided such that flow going to the brain was separated from the rest of the circuit. Air micro-emboli were injected either in the HLM (“ECC Bubbles”) or in the mock left ventricle (“Heart Bubbles”) to simulate the two sources. Emboli distribution was measured with an ultrasonic bubble counter. Five repetitions were performed for each combination of injection site and cannulation site, where air bubble counts and volumes were recorded. Air bubbles were separated in three categories based on size. Results For both injection sites, it was possible to identify statistically significant differences between cannulation sites. For ECC Bubbles, axillary cannulation led to a higher amount of air bubbles in the brain with medium-sized bubbles. For Heart Bubbles, aortic cannulation showed a significantly bigger embolic load in the brain with large bubbles. Conclusions These preliminary in vitro findings showed that air embolic load in the brain may be dependent on the cannulation site, which deserves further in vivo exploration.

Air Embolism on Cardiopulmonary Bypass

2019 ◽  
pp. 160-165
Author(s):  
Aaron Hudson ◽  
Ryan Hood
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Cardiopulmonary Bypass ◽  
Sudden Death ◽  
Air Embolism ◽  
Cardiac Surgical Procedures ◽  
Daily Basis ◽  
Team Members ◽  
Cardiac Surgeons ◽  
Almost All

The danger associated with air embolism in cardiac surgery has been well established for over 125 years. In the first volume of Annals of Surgery, published in 1885, long preceding the era of cardiac surgery and the use of extracorporeal circulatory techniques, Dr. Nicholas Senn alluded to the ensuing calamity caused by air embolism: “I intend on this occasion to call your attention to one of the most dreaded and, I may add, one of the most uncontrollable causes of sudden death—I allude to air-embolism.”1,2 Since the advent of modern cardiac surgery, much attention has been focused on the prevention of air embolism by cardiac surgeons, anesthesiologists, and perfusionists alike. Indeed, all three team members are critically responsible for the safe conduct of thousands of cardiac surgical procedures occurring on a daily basis worldwide. While the morbidity and mortality of massive air embolism is exceedingly high, most believe that with appropriate training and unwavering vigilance during clinical practice, almost all massive air emboli can be prevented.3

scholarly journals Perioperative Cerebral Ischaemia in Cardiac Surgery and BIS

2005 ◽  
Vol 33 (4) ◽  
pp. 514-517 ◽  
Author(s):  
J. Villacorta ◽  
F. Kerbaul ◽  
F. Collart ◽  
C. Guidon ◽  
M. Bonnet ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Ct Scan ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Bispectral Index ◽  
Cerebral Ischaemia ◽  
Air Embolism ◽  
Aortic Cross Clamp ◽  
Bispectral Index Monitoring

A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.

Brain Injury after Cerebral Arterial Air Embolism in the Rabbit as Determined by Triphenyltetrazolium Staining 

1999 ◽  
Vol 90 (5) ◽  
pp. 1462-1473 ◽  
Author(s):  
Bradley J. Hindman ◽  
Franklin Dexter ◽  
Alberto Subieta ◽  
Tom Smith ◽  
Johann Cutkomp
Keyword(s):  
Cardiac Surgery ◽  
Brain Injury ◽  
Evoked Potential ◽  
Air Embolism ◽  
Somatosensory Evoked Potential ◽  
Triphenyltetrazolium Chloride ◽  
Neurologic Dysfunction ◽  
Potential Amplitude ◽  
Neurologic Impairment ◽  
Positive Controls

Background Microscopic cerebral arterial air embolism (CAAE) occurs commonly during cardiac surgery and causes acute and chronic nonfocal neurologic dysfunction. Nevertheless, most neuroimaging studies do not detect brain injury after cardiac surgery. Using a rabbit model, the authors hypothesized they could detect and quantitate severe brain injury and infarction 24 h after microscopic CAAE using the vital stain triphenyltetrazolium chloride. Methods Experiments were conducted in methohexital anesthetized New Zealand white rabbits. Surgical shams (n = 5) underwent surgery but had no neurologic insult. Positive controls (n = 3) received 200 microl/kg of intracarotid air. Other animals were randomized to receive either 50 microl/kg intracarotid air, which produces microscopic CAAE (n = 18), or 300 microl intracarotid saline (control, n = 18). Outcomes included somatosensory evoked potential amplitude at 90 min, neurologic impairment score at 4 and 24 h (0 [normal] to 99 [coma]), and percentage of nonstaining brain at 24 h using color-discrimination image analysis. Severely injured or infarcted brain does not stain with triphenyltetrazolium chloride. Results Surgical shams had little neurologic impairment and a small amount of nonstaining brain at 24 h (5.2 +/- 2.4%; mean +/- SD). Positive controls had profound neurologic impairment and large amounts of nonstaining brain (40-97%). Ninety-minute somatosensory evoked potential amplitude was less in animals receiving 50 microl/kg air versus saline: 38 +/- 28% versus 102 +/- 32%, respectively, P < 1 x 10(-7). Neurologic impairment scores were greater in animals receiving 50 microl/kg air versus saline: at 4 h, 43 +/- 16 versus 23 +/- 9, P < 1 x 10(-7); at 24 h, 24 +/- 12 versus 15 +/- 8, P = 0.013. Nevertheless, there was no difference between 50 microl/kg air and saline in nonstaining brain: 5.5 +/- 2.9% versus 6.8 +/- 5.4%, P = 0.83. Conclusions Neurologic injury after CAAE is dose-dependent. Although microscopic CAAE causes somatosensory evoked potential abnormalities and neurologic dysfunction, severe cerebral injury or infarction is not present at 24 h. The author's findings are consistent with clinical imaging studies that suggest microscopic CAAE causes neurologic dysfunction even though overt infarction is absent.

scholarly journals Study of the Entropy as a Way to Detect Venous Air Embolism Using a Pre-cordial Doppler

2015 ◽  
Vol 1 (2) ◽  
pp. 39-44
Author(s):  
Ana Tedim ◽  
Pedro Amorim ◽  
Ana Castro
Keyword(s):  
Heart Sound ◽  
Air Embolism ◽  
Robust Methods ◽  
Clinical Protocol ◽  
Venous Air Embolism ◽  
Air Bubble ◽  
Cardiac Sound ◽  
Flow Turbulence ◽  
The Right ◽  
Increased Blood Flow

Venous air embolism (VAE) is the air bubble accumulation in the right side of the heart, or in the pulmonary region. Pre-cordial Doppler allows a real-time monitoring of heart sound and is used to detect VAE episodes through changes in cardiac sound. Sometimes these changes are not detected by the operator, which reveals the importance of finding other robust methods for VAE detection. This work aims to study entropy as a feature of the heart sound that may provide useful information on VAE episodes.A clinical protocol was designed: Doppler Heart Sound (DHS) was collected at baseline, and following infusions of saline with 4 distinct volumes and 2 infusion rates, and given through 2 infusion vias, to 4 patients enrolled in the clinical study. Entropy of these segments was obtained, and relation between the extracted feature and saline infusions was studied.Entropy presents a good performance showing an increase in response to saline injections (increased blood flow turbulence).

A New Device Preventing Air Embolism During the Angiography, Air Trap Device: An In-Vitro Experimental Air Emboli Study

2019 ◽  
Author(s):  
Haluk Un
Keyword(s):  
Tissue Damage ◽  
Air Embolism ◽  
Percutaneous Intervention ◽  
Experimental Results ◽  
Arterial System ◽  
Air Bubble ◽  
New Device ◽  
Air Embolus

Air embolism occurs when an air bubble enters the arterial system through the catheters. This can happen due to different reasons such as lack of attention, connection failure, or inexperience. This situation results in tissue damage in vital organs such as the heart and brain which may lead to death. To our knowledge, there is no technology preventing an air embolus from happening. Doctors try to prevent this complication with their attention and catheter control. In this project, a new air-trap device that prevents air embolus was tested in-vitro in air embolism model. Experimental results with a prototype showed that the new design was successful. Air embolism was blocked at various pressure-speed ranges. Air Trap device can be used to prevent air embolism by cardiologists, interventional radiologists and cardiovascular surgeons that perform a percutaneous intervention.

scholarly journals Venous Air Embolism Leading to Cardiac Arrest in an Infant with Cyanotic Congenital Heart Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Scott C. Watkins ◽  
Lewis McCarver ◽  
Alicia VanBebber ◽  
David P. Bichell
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cardiopulmonary Arrest ◽  
Air Embolism ◽  
Cyanotic Congenital Heart Disease ◽  
Gas Embolism ◽  
Venous Air Embolism ◽  
Important Complication

Gas emboli, including venous and arterial, are a rare but important complication of pediatric cardiac surgery. They have the potential to have devastating consequences and require prompt recognition and treatment. We present a case of gas embolism occurring in the immediate postoperative period in an infant with cyanotic congenital heart disease after palliative cardiac surgery resulting in cardiopulmonary arrest. The embolism was diagnosed by visualization of air within the vessel creating an airlock and occluding pulmonary blood flow.

scholarly journals Study of the Entropy as a Way to Detect Venous Air Embolism Using a Pre-cordial Doppler

2018 ◽  
Vol 1 (2) ◽  
pp. 39-44
Author(s):  
Ana Tedim ◽  
Pedro Amorim ◽  
Ana Castro
Keyword(s):  
Heart Sound ◽  
Air Embolism ◽  
Robust Methods ◽  
Clinical Protocol ◽  
Venous Air Embolism ◽  
Air Bubble ◽  
Cardiac Sound ◽  
Flow Turbulence ◽  
The Right ◽  
Increased Blood Flow

Venous air embolism (VAE) is the air bubble accumulation in the right side of the heart, or in the pulmonary region. Pre-cordial Doppler allows a real-time monitoring of heart sound and is used to detect VAE episodes through changes in cardiac sound. Sometimes these changes are not detected by the operator, which reveals the importance of finding other robust methods for VAE detection. This work aims to study entropy as a feature of the heart sound that may provide useful information on VAE episodes.A clinical protocol was designed: Doppler Heart Sound (DHS) was collected at baseline, and following infusions of saline with 4 distinct volumes and 2 infusion rates, and given through 2 infusion vias, to 4 patients enrolled in the clinical study. Entropy of these segments was obtained, and relation between the extracted feature and saline infusions was studied.Entropy presents a good performance showing an increase in response to saline injections (increased blood flow turbulence).

Sign in / Sign up

Export Citation Format

Share Document