膜式氧合器及动脉滤器祛泡功能的探讨

Evaluation of the Ability of Membrane Oxygenator and the Arterial Filter to Remove the Gaseous Microemboli

目的评价A ffin ity、Edwards和Terumo三种膜式氧合器祛泡能力,并探讨使用膜式氧合器时动脉滤器使用的必要性。方法使用18例心脏手术后体外循环装置,分别为A ffin ity、Edwards和Terumo SX18三种成人膜式氧合器各6例,并均使用Terumo动脉滤器,在同等的检测条件下用注射器在膜式氧合器前的管路中注入30 m l空气,使用CMD-20超声波微气栓检测仪检测空气通过膜式氧合器后及动脉滤器后产生的微气栓数量。结果在膜式氧合器及动脉滤器后血流中测得微气栓平均数量分别为:A ffin ity(155.9±15.2)个和(69.869.8±6.7)个;Edwards(336.0±14.7)个和(135.3±6.1)个;Terumo(114.6±12.1)个和(52.8±5.5)个。结论不同的膜式氧合器有不同的祛泡能力;使用动脉滤器可显著降低体外循环产生微气栓的风险。

OBJECTIVE To investigate the ability to remove the gaseous microomboli of three kinds of membrane oxygenator,and the necessity to use arterial filter for membrane oxygenator. METHODS To choose 18 extracorporeal circulation circuits after open heart surgery. Three kinds of membrane oxygenator （ Affinity, Edwards and Terumo, n = 6 ） and arterial filter were estimated for removing of gaseous microemboli. Counts of gaseous microemboli after membrane oxygenator and after arterial filter were tested in each group with Micro Bubble Counter （ CMD - 20 Terumo） under the same condition. RESULTS Counts of gaseous microemboli after different membrane oxygenator and after arterial filter were as following： （155.9 ±15.2） and （69.8 ±6.7） for Affinity, （336.0±14.7） and （135.3 ±6.1） for Edwards,（114.6 ± 12. 1 ） and （52.8 ± 5.5 ） for Terumo . CONCLUSION The ability to remove gaseous microemboli is different for different membrane oxygenators. Arterial filter is necessary for extracorporal cirulation with membrane oxygenator to furtherly reduce the risk of engendering gaseous.