The Experts below are selected from a list of 1920 Experts worldwide ranked by ideXlab platform
Akif Ündar - One of the best experts on this subject based on the ideXlab platform.
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in vitro evaluation of capiox fx05 and rx05 oxygenators in neonatal cardiopulmonary bypass circuits with varying venous reservoir and vacuum assisted venous drainage levels
Artificial Organs, 2020Co-Authors: Shyama Sathianathan, Shigang Wang, Allen R Kunselman, Rafay Nasir, Akif ÜndarAbstract:The purpose of this study was to evaluate the hemodynamic properties and microemboli capture associated with different vacuum-assisted venous drainage (VAVD) vacuum levels and venous reservoir levels in a neonatal cardiopulmonary bypass circuit. Trials were conducted in 2 parallel circuits to compare the performance of Capiox Baby RX05 oxygenator with separate AF02 Arterial Filter to Capiox FX05 oxygenator with integrated Arterial Filter. Arterial cannula flow rate to the patient was held at 500 mL/min and temperature maintained at 32°C, while VAVD vacuum levels (0 mm Hg, -15 mm Hg, -30 mm Hg, -45 mm Hg, -60 mm Hg) and venous reservoir levels (50 mL, 200 mL) were evaluated in both oxygenators. Hemodynamic parameters measuring flow, pressure, and total hemodynamic energy were made in real time using a custom-made data acquisition system and Labview software. Nearly 10 cc bolus of air was injected into the venous line and gaseous microemboli detected using an Emboli Detection and Classification Quantifier. Diverted blood flow via the Arterial Filter's purge line and mean pressures increased with increasing VAVD levels (P < 0.01). Mean pressures were lower with lower venous reservoir levels and were greater in RX05 groups compared to FX05 (P < 0.01). Microemboli detected at the preoxygenator site increased with higher VAVD vacuum levels and lower venous reservoir levels (P < 0.01). The amount of microemboli captured by the FX05 oxygenator with integrated Arterial Filter was greater than by the RX05 oxygenator alone, although both oxygenators were able to clear microemboli before reaching the pseudo-patient.
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in vitro comparison of pediatric oxygenators with and without integrated Arterial Filters in maintaining optimal hemodynamic stability and managing gaseous microemboli
Artificial Organs, 2018Co-Authors: Morgan K Moroi, Shigang Wang, Allen R Kunselman, Madison Force, Akif ÜndarAbstract:The purpose of this study was to compare the Capiox FX15 oxygenator with integrated Arterial Filter to the Capiox RX15 oxygenator with separate Capiox AF125 Arterial Filter in terms of hemodynamic properties and gaseous microemboli (GME) capturing. Trials were conducted at varying flow rates (2.0 L/min, 3.0 L/min, 4.0 L/min), temperatures (30°C, 35°C), and flow modalities (pulsatile, nonpulsatile). Pressure and flow waveforms were recorded using a custom-made data acquisition system. GME data were recorded using an Emboli Detection and Classification Quantifier after injecting a 5 mL air bolus into the venous line. Maximum instantaneous pre-oxygenator flows reached 7.4 L/min under pulsatile conditions when the roller pump was set to a flow rate of 4 L/min. Mean pressure drops were slightly greater in the FX15 group (P < 0.0001), and the diverted flow from the Arterial purge line was slighter greater in the FX15 group at 3 L/min and 4 L/min (P < 0.0001). There was a slight generation of surplus hemodynamic energy (SHE) at the pre-oxygenator site for both oxygenators under "nonpulsatile mode." However, higher pre-oxygenator SHE levels were recorded for both groups with "pulsatile mode." The RX15 and FX15 groups were both able to remove all microemboli from the circuit at 2 L/min and 3 L/min in "nonpulsatile mode." Microemboli were delivered to the patient at 4 L/min with pulsatile flows in both groups. The RX15 oxygenator with separate AF125 Arterial Filter and FX15 oxygenator with integrated Arterial Filter performed similarly in terms of hemodynamic performance and microemboli capturing. Pulsatile flows at 4 L/min produced instantaneous flow rates that surpassed the documented maximum flow rates of the oxygenators and might have contributed to the delivery of GME to the pseudo-patient.
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in vitro evaluation of pediatric hollow fiber membrane oxygenators on hemodynamic performance and gaseous microemboli handling an international multicenter multidisciplinary approach
Artificial Organs, 2017Co-Authors: Shigang Wang, Allen R Kunselman, Luiz Fernando Caneo, Fabio Biscegli Jatene, Marcelo B Jatene, Idagene A Cestari, Akif ÜndarAbstract:The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an Arterial Filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated Arterial Filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr Arterial cannula, primed with lactated Ringer's solution and packed red blood cells. Trials were conducted at flow rates ranging from 500 to 2000 mL/min (500 mL/min increment) at 35°C and 28°C. Real-time pressure and flow data were recorded using a custom-based data acquisition system. For GME testing, 5 cc of air was manually injected into the venous line. GME were recorded using the Emboli Detection and Classification Quantifier (EDAC) System. An additional experiment using a separate Arterial Filter was conducted. There was no difference in the mean circuit pressure, pressure drop, total hemodynamic energy level, and energy loss between the two oxygenators. The venous line pressures were higher in the Braile than in the Quadrox group during all trials (P <0.01). GME count and volume at pre-/post oxygenator and pre-cannula sites in the Quadrox were lower than the Braile group at high flow rates (P < 0.05). In the additional experiment, an Arterial Filter captured a significant number of microemboli at all flow rates. The Braile Infant oxygenator has a matched hemodynamic characteristic with the Quadrox-i Pediatric oxygenator. The Quadrox-i has a better GME handling ability compared with the Braile Infant oxygenator. Regardless of type of oxygenator an additional Arterial Filter decreases the number of GME.
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evaluation of capiox rx25 and quadrox i adult hollow fiber membrane oxygenators in a simulated cardiopulmonary bypass circuit
Artificial Organs, 2016Co-Authors: Shigang Wang, Allen R Kunselman, Akif ÜndarAbstract:The Capiox RX25 and Quadrox-i Adult oxygenators are commonly used in clinical adult cardiopulmonary bypass circuits. This study was designed to test the effectiveness of two adult oxygenators in order to evaluate gaseous microemboli (GME) trapping capability and hemodynamic performance. A simulated adult CPB circuit was used and primed with Ringer's lactate and packed red blood cells (hematocrit 25%). All trials were conducted at flow rates of 2-5 L/min (1 L/min increments) with a closed and open Arterial Filter purge line at 35°C. The postcannula pressure was maintained at 100 mm Hg. After a 5 cc of bolus air was introduced into the venous line, an Emboli Detection and Classification system was used to detect and classify GME at the preoxygenator, postoxygenator, and precannula sites. At the same time, real-time pressure and flow data were recorded, and hemodynamic energy was calculated using a custom-made data acquisition system and Labview software. Our results showed that the oxygenator pressure drops of Quadrox-i Adult oxygenator were lower than Capiox RX25 at all flow rates. The Quadrox-i Adult oxygenator retained more hemodynamic energy across the oxygenator. Both oxygenators could trap the majority of GME, but Capiox RX25 did better than the Quadrox-i Adult oxygenator. No GME was delivered to the pseudo patient at all flow rates in the Capiox group. The Capiox RX25 venous reservoir could capture more GME at lower flow rates, while the Quadrox-i Adult venous reservoir performed better at higher flow rates. An open Arterial Filter purge line reduced GME slightly in the Capiox group, but GME increased in the Quadrox group. The Quadrox-i Adult oxygenator is a low-resistance, high-compliance oxygenator. The GME handling ability of Capiox RX25 performed well under our clinical setting. Further optimized design for the venous/cardiotomy reservoir is needed.
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in vitro hemodynamic evaluation of five 6 fr and 8 fr Arterial cannulae in simulated neonatal cardiopulmonary bypass circuits
Artificial Organs, 2016Co-Authors: Shigang Wang, Akif Ündar, David Palanzo, Allen R KunselmanAbstract:The objective of this study was to evaluate five small-bore Arterial cannulae (6Fr and 8Fr) in terms of pressure drop and hemodynamic performance in simulated neonatal cardiopulmonary bypass (CPB) circuits. The experimental circuits consisted of a Jostra HL-20 roller pump, a Terumo Capiox Baby FX05 oxygenator with integrated Arterial Filter, an Arterial and a venous tubing (1/4, 3/16, or 1/8 in × 150 cm), and an Arterial cannula (Medtronic Bio-Medicus 6Fr and 8Fr, Maquet 6Fr and 8Fr, or RMI Edwards 8Fr). The circuit was primed using lactated Ringer's solution and heparinized packed human red blood cells (hematocrit 30%). Trials were conducted at different flow rates (6Fr: 200-400 mL/min; 8Fr: 200-600 mL/min) and temperatures (35 and 28°C). Flow and pressure data were collected using a custom-based data acquisition system. Higher circuit pressure, circuit pressure drop, and hemodynamic energy loss across the circuit were recorded when using small-bore Arterial cannula and small inner diameter Arterial tubing in a neonatal CPB circuit. The maximum preoxygenator pressures reached 449.7 ± 1.0 mm Hg (Maquet 6Fr at 400 mL/min), and 395.7 ± 0.4 mm Hg (DLP 8Fr at 600 mL/min) when using 1/8 in ID Arterial tubing at 28°C. Hypothermia further increased circuit pressure drop and hemodynamic energy loss. Compared with the others, the RMI 8Fr Arterial cannula had significantly lower pressure drop and energy loss. Maquet 6Fr Arterial cannula had a greater pressure drop than the DLP 6Fr. A small-bore Arterial cannula and Arterial tubing created high circuit pressure drop and hemodynamic energy loss. Appropriate Arterial cannula and Arterial tubing should be considered to match the expected flow rate. Larger cannula and tubing are recommended for neonatal CPB. Low-resistance neonatal Arterial cannulae need to be developed.
Shigang Wang - One of the best experts on this subject based on the ideXlab platform.
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pumping o2 with no n2 an overview of hollow fiber membrane oxygenators with integrated Arterial Filters
Current Topics in Medicinal Chemistry, 2020Co-Authors: Anxin Liu, Zhiquan Sun, Qier Liu, Ning Zhu, Shigang WangAbstract:The advancement of cardiac surgery benefits from the continual technological progress of cardiopulmonary bypass (CPB). Every improvement in the CPB technology requires further clinical and laboratory tests to prove its safety and effectiveness before it can be widely used in clinical practice. In order to reduce the priming volume and eliminate a separate Arterial Filter in the CPB circuit, several manufacturers developed novel hollow-fiber membrane oxygenators with integrated Arterial Filters (IAF). Clinical and experimental studies demonstrated that an oxygenator with IAF could reduce total priming volume, blood donor exposure and gaseous microemboli delivery to the patient. It can be easily set up and managed, simplifying the CPB circuit without sacrificing safety. An oxygenator with IAF is expected to be more beneficial to the patients with low body weight and when using a minimized extracorporeal circulation system. The aim of this review manuscript was to discuss briefly the concept of integration, the current oxygenators with IAF, and the in-vitro / in-vivo performance of the oxygenators with IAF.
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in vitro evaluation of capiox fx05 and rx05 oxygenators in neonatal cardiopulmonary bypass circuits with varying venous reservoir and vacuum assisted venous drainage levels
Artificial Organs, 2020Co-Authors: Shyama Sathianathan, Shigang Wang, Allen R Kunselman, Rafay Nasir, Akif ÜndarAbstract:The purpose of this study was to evaluate the hemodynamic properties and microemboli capture associated with different vacuum-assisted venous drainage (VAVD) vacuum levels and venous reservoir levels in a neonatal cardiopulmonary bypass circuit. Trials were conducted in 2 parallel circuits to compare the performance of Capiox Baby RX05 oxygenator with separate AF02 Arterial Filter to Capiox FX05 oxygenator with integrated Arterial Filter. Arterial cannula flow rate to the patient was held at 500 mL/min and temperature maintained at 32°C, while VAVD vacuum levels (0 mm Hg, -15 mm Hg, -30 mm Hg, -45 mm Hg, -60 mm Hg) and venous reservoir levels (50 mL, 200 mL) were evaluated in both oxygenators. Hemodynamic parameters measuring flow, pressure, and total hemodynamic energy were made in real time using a custom-made data acquisition system and Labview software. Nearly 10 cc bolus of air was injected into the venous line and gaseous microemboli detected using an Emboli Detection and Classification Quantifier. Diverted blood flow via the Arterial Filter's purge line and mean pressures increased with increasing VAVD levels (P < 0.01). Mean pressures were lower with lower venous reservoir levels and were greater in RX05 groups compared to FX05 (P < 0.01). Microemboli detected at the preoxygenator site increased with higher VAVD vacuum levels and lower venous reservoir levels (P < 0.01). The amount of microemboli captured by the FX05 oxygenator with integrated Arterial Filter was greater than by the RX05 oxygenator alone, although both oxygenators were able to clear microemboli before reaching the pseudo-patient.
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in vitro comparison of pediatric oxygenators with and without integrated Arterial Filters in maintaining optimal hemodynamic stability and managing gaseous microemboli
Artificial Organs, 2018Co-Authors: Morgan K Moroi, Shigang Wang, Allen R Kunselman, Madison Force, Akif ÜndarAbstract:The purpose of this study was to compare the Capiox FX15 oxygenator with integrated Arterial Filter to the Capiox RX15 oxygenator with separate Capiox AF125 Arterial Filter in terms of hemodynamic properties and gaseous microemboli (GME) capturing. Trials were conducted at varying flow rates (2.0 L/min, 3.0 L/min, 4.0 L/min), temperatures (30°C, 35°C), and flow modalities (pulsatile, nonpulsatile). Pressure and flow waveforms were recorded using a custom-made data acquisition system. GME data were recorded using an Emboli Detection and Classification Quantifier after injecting a 5 mL air bolus into the venous line. Maximum instantaneous pre-oxygenator flows reached 7.4 L/min under pulsatile conditions when the roller pump was set to a flow rate of 4 L/min. Mean pressure drops were slightly greater in the FX15 group (P < 0.0001), and the diverted flow from the Arterial purge line was slighter greater in the FX15 group at 3 L/min and 4 L/min (P < 0.0001). There was a slight generation of surplus hemodynamic energy (SHE) at the pre-oxygenator site for both oxygenators under "nonpulsatile mode." However, higher pre-oxygenator SHE levels were recorded for both groups with "pulsatile mode." The RX15 and FX15 groups were both able to remove all microemboli from the circuit at 2 L/min and 3 L/min in "nonpulsatile mode." Microemboli were delivered to the patient at 4 L/min with pulsatile flows in both groups. The RX15 oxygenator with separate AF125 Arterial Filter and FX15 oxygenator with integrated Arterial Filter performed similarly in terms of hemodynamic performance and microemboli capturing. Pulsatile flows at 4 L/min produced instantaneous flow rates that surpassed the documented maximum flow rates of the oxygenators and might have contributed to the delivery of GME to the pseudo-patient.
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in vitro evaluation of pediatric hollow fiber membrane oxygenators on hemodynamic performance and gaseous microemboli handling an international multicenter multidisciplinary approach
Artificial Organs, 2017Co-Authors: Shigang Wang, Allen R Kunselman, Luiz Fernando Caneo, Fabio Biscegli Jatene, Marcelo B Jatene, Idagene A Cestari, Akif ÜndarAbstract:The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an Arterial Filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated Arterial Filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr Arterial cannula, primed with lactated Ringer's solution and packed red blood cells. Trials were conducted at flow rates ranging from 500 to 2000 mL/min (500 mL/min increment) at 35°C and 28°C. Real-time pressure and flow data were recorded using a custom-based data acquisition system. For GME testing, 5 cc of air was manually injected into the venous line. GME were recorded using the Emboli Detection and Classification Quantifier (EDAC) System. An additional experiment using a separate Arterial Filter was conducted. There was no difference in the mean circuit pressure, pressure drop, total hemodynamic energy level, and energy loss between the two oxygenators. The venous line pressures were higher in the Braile than in the Quadrox group during all trials (P <0.01). GME count and volume at pre-/post oxygenator and pre-cannula sites in the Quadrox were lower than the Braile group at high flow rates (P < 0.05). In the additional experiment, an Arterial Filter captured a significant number of microemboli at all flow rates. The Braile Infant oxygenator has a matched hemodynamic characteristic with the Quadrox-i Pediatric oxygenator. The Quadrox-i has a better GME handling ability compared with the Braile Infant oxygenator. Regardless of type of oxygenator an additional Arterial Filter decreases the number of GME.
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evaluation of capiox rx25 and quadrox i adult hollow fiber membrane oxygenators in a simulated cardiopulmonary bypass circuit
Artificial Organs, 2016Co-Authors: Shigang Wang, Allen R Kunselman, Akif ÜndarAbstract:The Capiox RX25 and Quadrox-i Adult oxygenators are commonly used in clinical adult cardiopulmonary bypass circuits. This study was designed to test the effectiveness of two adult oxygenators in order to evaluate gaseous microemboli (GME) trapping capability and hemodynamic performance. A simulated adult CPB circuit was used and primed with Ringer's lactate and packed red blood cells (hematocrit 25%). All trials were conducted at flow rates of 2-5 L/min (1 L/min increments) with a closed and open Arterial Filter purge line at 35°C. The postcannula pressure was maintained at 100 mm Hg. After a 5 cc of bolus air was introduced into the venous line, an Emboli Detection and Classification system was used to detect and classify GME at the preoxygenator, postoxygenator, and precannula sites. At the same time, real-time pressure and flow data were recorded, and hemodynamic energy was calculated using a custom-made data acquisition system and Labview software. Our results showed that the oxygenator pressure drops of Quadrox-i Adult oxygenator were lower than Capiox RX25 at all flow rates. The Quadrox-i Adult oxygenator retained more hemodynamic energy across the oxygenator. Both oxygenators could trap the majority of GME, but Capiox RX25 did better than the Quadrox-i Adult oxygenator. No GME was delivered to the pseudo patient at all flow rates in the Capiox group. The Capiox RX25 venous reservoir could capture more GME at lower flow rates, while the Quadrox-i Adult venous reservoir performed better at higher flow rates. An open Arterial Filter purge line reduced GME slightly in the Capiox group, but GME increased in the Quadrox group. The Quadrox-i Adult oxygenator is a low-resistance, high-compliance oxygenator. The GME handling ability of Capiox RX25 performed well under our clinical setting. Further optimized design for the venous/cardiotomy reservoir is needed.
Allen R Kunselman - One of the best experts on this subject based on the ideXlab platform.
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in vitro evaluation of capiox fx05 and rx05 oxygenators in neonatal cardiopulmonary bypass circuits with varying venous reservoir and vacuum assisted venous drainage levels
Artificial Organs, 2020Co-Authors: Shyama Sathianathan, Shigang Wang, Allen R Kunselman, Rafay Nasir, Akif ÜndarAbstract:The purpose of this study was to evaluate the hemodynamic properties and microemboli capture associated with different vacuum-assisted venous drainage (VAVD) vacuum levels and venous reservoir levels in a neonatal cardiopulmonary bypass circuit. Trials were conducted in 2 parallel circuits to compare the performance of Capiox Baby RX05 oxygenator with separate AF02 Arterial Filter to Capiox FX05 oxygenator with integrated Arterial Filter. Arterial cannula flow rate to the patient was held at 500 mL/min and temperature maintained at 32°C, while VAVD vacuum levels (0 mm Hg, -15 mm Hg, -30 mm Hg, -45 mm Hg, -60 mm Hg) and venous reservoir levels (50 mL, 200 mL) were evaluated in both oxygenators. Hemodynamic parameters measuring flow, pressure, and total hemodynamic energy were made in real time using a custom-made data acquisition system and Labview software. Nearly 10 cc bolus of air was injected into the venous line and gaseous microemboli detected using an Emboli Detection and Classification Quantifier. Diverted blood flow via the Arterial Filter's purge line and mean pressures increased with increasing VAVD levels (P < 0.01). Mean pressures were lower with lower venous reservoir levels and were greater in RX05 groups compared to FX05 (P < 0.01). Microemboli detected at the preoxygenator site increased with higher VAVD vacuum levels and lower venous reservoir levels (P < 0.01). The amount of microemboli captured by the FX05 oxygenator with integrated Arterial Filter was greater than by the RX05 oxygenator alone, although both oxygenators were able to clear microemboli before reaching the pseudo-patient.
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in vitro comparison of pediatric oxygenators with and without integrated Arterial Filters in maintaining optimal hemodynamic stability and managing gaseous microemboli
Artificial Organs, 2018Co-Authors: Morgan K Moroi, Shigang Wang, Allen R Kunselman, Madison Force, Akif ÜndarAbstract:The purpose of this study was to compare the Capiox FX15 oxygenator with integrated Arterial Filter to the Capiox RX15 oxygenator with separate Capiox AF125 Arterial Filter in terms of hemodynamic properties and gaseous microemboli (GME) capturing. Trials were conducted at varying flow rates (2.0 L/min, 3.0 L/min, 4.0 L/min), temperatures (30°C, 35°C), and flow modalities (pulsatile, nonpulsatile). Pressure and flow waveforms were recorded using a custom-made data acquisition system. GME data were recorded using an Emboli Detection and Classification Quantifier after injecting a 5 mL air bolus into the venous line. Maximum instantaneous pre-oxygenator flows reached 7.4 L/min under pulsatile conditions when the roller pump was set to a flow rate of 4 L/min. Mean pressure drops were slightly greater in the FX15 group (P < 0.0001), and the diverted flow from the Arterial purge line was slighter greater in the FX15 group at 3 L/min and 4 L/min (P < 0.0001). There was a slight generation of surplus hemodynamic energy (SHE) at the pre-oxygenator site for both oxygenators under "nonpulsatile mode." However, higher pre-oxygenator SHE levels were recorded for both groups with "pulsatile mode." The RX15 and FX15 groups were both able to remove all microemboli from the circuit at 2 L/min and 3 L/min in "nonpulsatile mode." Microemboli were delivered to the patient at 4 L/min with pulsatile flows in both groups. The RX15 oxygenator with separate AF125 Arterial Filter and FX15 oxygenator with integrated Arterial Filter performed similarly in terms of hemodynamic performance and microemboli capturing. Pulsatile flows at 4 L/min produced instantaneous flow rates that surpassed the documented maximum flow rates of the oxygenators and might have contributed to the delivery of GME to the pseudo-patient.
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in vitro evaluation of pediatric hollow fiber membrane oxygenators on hemodynamic performance and gaseous microemboli handling an international multicenter multidisciplinary approach
Artificial Organs, 2017Co-Authors: Shigang Wang, Allen R Kunselman, Luiz Fernando Caneo, Fabio Biscegli Jatene, Marcelo B Jatene, Idagene A Cestari, Akif ÜndarAbstract:The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an Arterial Filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated Arterial Filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr Arterial cannula, primed with lactated Ringer's solution and packed red blood cells. Trials were conducted at flow rates ranging from 500 to 2000 mL/min (500 mL/min increment) at 35°C and 28°C. Real-time pressure and flow data were recorded using a custom-based data acquisition system. For GME testing, 5 cc of air was manually injected into the venous line. GME were recorded using the Emboli Detection and Classification Quantifier (EDAC) System. An additional experiment using a separate Arterial Filter was conducted. There was no difference in the mean circuit pressure, pressure drop, total hemodynamic energy level, and energy loss between the two oxygenators. The venous line pressures were higher in the Braile than in the Quadrox group during all trials (P <0.01). GME count and volume at pre-/post oxygenator and pre-cannula sites in the Quadrox were lower than the Braile group at high flow rates (P < 0.05). In the additional experiment, an Arterial Filter captured a significant number of microemboli at all flow rates. The Braile Infant oxygenator has a matched hemodynamic characteristic with the Quadrox-i Pediatric oxygenator. The Quadrox-i has a better GME handling ability compared with the Braile Infant oxygenator. Regardless of type of oxygenator an additional Arterial Filter decreases the number of GME.
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evaluation of capiox rx25 and quadrox i adult hollow fiber membrane oxygenators in a simulated cardiopulmonary bypass circuit
Artificial Organs, 2016Co-Authors: Shigang Wang, Allen R Kunselman, Akif ÜndarAbstract:The Capiox RX25 and Quadrox-i Adult oxygenators are commonly used in clinical adult cardiopulmonary bypass circuits. This study was designed to test the effectiveness of two adult oxygenators in order to evaluate gaseous microemboli (GME) trapping capability and hemodynamic performance. A simulated adult CPB circuit was used and primed with Ringer's lactate and packed red blood cells (hematocrit 25%). All trials were conducted at flow rates of 2-5 L/min (1 L/min increments) with a closed and open Arterial Filter purge line at 35°C. The postcannula pressure was maintained at 100 mm Hg. After a 5 cc of bolus air was introduced into the venous line, an Emboli Detection and Classification system was used to detect and classify GME at the preoxygenator, postoxygenator, and precannula sites. At the same time, real-time pressure and flow data were recorded, and hemodynamic energy was calculated using a custom-made data acquisition system and Labview software. Our results showed that the oxygenator pressure drops of Quadrox-i Adult oxygenator were lower than Capiox RX25 at all flow rates. The Quadrox-i Adult oxygenator retained more hemodynamic energy across the oxygenator. Both oxygenators could trap the majority of GME, but Capiox RX25 did better than the Quadrox-i Adult oxygenator. No GME was delivered to the pseudo patient at all flow rates in the Capiox group. The Capiox RX25 venous reservoir could capture more GME at lower flow rates, while the Quadrox-i Adult venous reservoir performed better at higher flow rates. An open Arterial Filter purge line reduced GME slightly in the Capiox group, but GME increased in the Quadrox group. The Quadrox-i Adult oxygenator is a low-resistance, high-compliance oxygenator. The GME handling ability of Capiox RX25 performed well under our clinical setting. Further optimized design for the venous/cardiotomy reservoir is needed.
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in vitro hemodynamic evaluation of five 6 fr and 8 fr Arterial cannulae in simulated neonatal cardiopulmonary bypass circuits
Artificial Organs, 2016Co-Authors: Shigang Wang, Akif Ündar, David Palanzo, Allen R KunselmanAbstract:The objective of this study was to evaluate five small-bore Arterial cannulae (6Fr and 8Fr) in terms of pressure drop and hemodynamic performance in simulated neonatal cardiopulmonary bypass (CPB) circuits. The experimental circuits consisted of a Jostra HL-20 roller pump, a Terumo Capiox Baby FX05 oxygenator with integrated Arterial Filter, an Arterial and a venous tubing (1/4, 3/16, or 1/8 in × 150 cm), and an Arterial cannula (Medtronic Bio-Medicus 6Fr and 8Fr, Maquet 6Fr and 8Fr, or RMI Edwards 8Fr). The circuit was primed using lactated Ringer's solution and heparinized packed human red blood cells (hematocrit 30%). Trials were conducted at different flow rates (6Fr: 200-400 mL/min; 8Fr: 200-600 mL/min) and temperatures (35 and 28°C). Flow and pressure data were collected using a custom-based data acquisition system. Higher circuit pressure, circuit pressure drop, and hemodynamic energy loss across the circuit were recorded when using small-bore Arterial cannula and small inner diameter Arterial tubing in a neonatal CPB circuit. The maximum preoxygenator pressures reached 449.7 ± 1.0 mm Hg (Maquet 6Fr at 400 mL/min), and 395.7 ± 0.4 mm Hg (DLP 8Fr at 600 mL/min) when using 1/8 in ID Arterial tubing at 28°C. Hypothermia further increased circuit pressure drop and hemodynamic energy loss. Compared with the others, the RMI 8Fr Arterial cannula had significantly lower pressure drop and energy loss. Maquet 6Fr Arterial cannula had a greater pressure drop than the DLP 6Fr. A small-bore Arterial cannula and Arterial tubing created high circuit pressure drop and hemodynamic energy loss. Appropriate Arterial cannula and Arterial tubing should be considered to match the expected flow rate. Larger cannula and tubing are recommended for neonatal CPB. Low-resistance neonatal Arterial cannulae need to be developed.
Hella Dominique - One of the best experts on this subject based on the ideXlab platform.
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Elimination des microembolies gazeuses durant la procédure de priming utilisant le débit pulsé, avec 4 oxygénateurs différents, équipés d'un réservoir veineux ouvert et d'un filtre artériel intégré.
2016Co-Authors: Hella DominiqueAbstract:4 oxygenators with open reservoir and integrated Arterial Filter were tested in pulsatile flow, during priming procedure. 2 got better results. We can not conclude if we could get the same results in clinical practice with blood and surgical events...Peer reviewe
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Elimination des microembolies gazeuses durant la procédure de priming utilisant le débit pulsé, avec 4 oxygénateurs différents, équipés d'un réservoir veineux ouvert et d'un filtre artériel intégré.
2016Co-Authors: Hella DominiqueAbstract:peer reviewedaudience: professional4 oxygenators with open reservoir and integrated Arterial Filter were tested in pulsatile flow, during priming procedure. 2 got better results. We can not conclude if we could get the same results in clinical practice with blood and surgical events..
Feng Qiu - One of the best experts on this subject based on the ideXlab platform.
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evaluation of quadrox i and capiox fx neonatal oxygenators with integrated Arterial Filters in eliminating gaseous microemboli and retaining hemodynamic properties during simulated cardiopulmonary bypass
Perfusion, 2012Co-Authors: J Lin, Allen R Kunselman, Feng Qiu, N M Dogal, R K Mathis, Akif ÜndarAbstract:Perfusion quality during cardiopulmonary bypass (CPB) procedures can contribute to postoperative neurological complications and influence patient recovery and outcome. Gaseous microemboli generated in the circuit and hemodynamic properties of blood reaching the patient can be monitored during CPB to optimize perfusion. Oxygenators that oxygenate the blood during CPB can significantly influence the quality of blood reaching the patient by their manufacturing designs. New hollow-fiber membrane oxygenators are developed with integrated Arterial Filters to reduce priming volume and eliminate a separate Arterial Filter in the circuit. To evaluate the performance of these new oxygenators, we used a simulated model to compare the Quadrox-i Neonatal and the Capiox Baby FX05 neonatal oxygenators and to provide a review of these oxygenators with their respective counterparts which have separate Arterial Filters. We found that microemboli counts for the new Quadrox-i and Capiox FX05 oxygenators are similar in the ar...
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evaluation of hl 20 roller pump and rotaflow centrifugal pump on perfusion quality and gaseous microemboli delivery
Artificial Organs, 2010Co-Authors: Stella Yee, Yulong Guan, Allen R Kunselman, Feng Qiu, Alan R Rider, Akif ÜndarAbstract:The purpose of this study was to compare the HL-20 roller pump (Jostra USA, Austin, TX, USA) and Rotaflow centrifugal pump (Jostra USA) on hemodynamic energy production and gaseous microemboli (GME) delivery in a simulated neonatal cardiopulmonary bypass (CPB) circuit under nonpulsatile perfusion. This study employed a simulated model of the pediatric CPB including a Jostra HL-20 heart-lung machine (or a Rotaflow centrifugal pump), a Capiox BabyRX05 oxygenator (Terumo Corporation, Tokyo, Japan), a Capiox pediatric Arterial Filter (Terumo Corporation), and ¼-inch tubing. The total volume of the experimental system was 700mL (500mL for the circuit and 200mL for the pseudo neonatal patient). The hematocrit was maintained at 30% using human blood. At the beginning of each trial, a 5mL bolus of air was injected into the venous line. Both GME data and pressure values were recorded at postpump and postoxygenator sites. All the experiments were conducted under nonpulsatile perfusion at three flow rates (500, 750, and 1000mL/min) and three blood temperatures (35, 30, and 25°C). As n=6 for each setup, a total of 108 trials were done. The total number of GME increased as temperature decreased from 35°C to 25°C in the trials using the HL-20 roller pump while the opposite effect occurred when using the Rotaflow centrifugal pump. At a given temperature, total GME counts increased with increasing flow rates for both pumps. Results indicated the Rotaflow centrifugal pump delivered significantly fewer microemboli compared to the HL-20 roller pump, especially under high flow rates. Less than 10% of total microemboli were larger than 40µm in size and the majority of GME were in the 0-20µm class in all trials. Postpump total hemodynamic energy (THE) increased with increasing flow rates and decreasing temperatures in both circuits using these two pumps. The HL-20 roller pump delivered more THE than the Rotaflow centrifugal pump at all tested flow rates and temperature conditions. Results suggest the HL-20 roller pump delivers more GME than the Rotaflow centrifugal pump but produces more hemodynamic energy under nonpulsatile perfusion mode.
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evaluation of capiox fx05 oxygenator with an integrated Arterial Filter on trapping gaseous microemboli and pressure drop with open and closed purge line
Artificial Organs, 2010Co-Authors: Feng Qiu, Sophia Peng, Alle R Kunselma, Akif UndaAbstract:Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass (CPB) because there is a positive correlation between microemboli exposure during CPB and postoperative neurological injury. Thus, minimizing the number of GME delivered to pediatric patients undergoing CPB procedures would lead to better clinical outcomes. In this study, we used a simulated CPB model to evaluate the effectiveness of capturing GME and the degree of membrane pressure drop for a new membrane oxygenator, Capiox Baby FX05 (Terumo Corporation,Tokyo, Japan), which has an integrated Arterial Filter with open and closed purge line.We used identical components in this study as our clinical CPB circuit. Three emboli detection and classification quantifier transducers were placed at prepump, preoxygenator, and postoxygenator sites in the circuit.Two flow probes as well as three pressure transducers were placed upstream and downstream of the oxygenator. The system was primed with human blood titrated to 30% hematocrit with Lactated Ringer’s solution.A bolus of air (1 mL) was injected in the prepump site under nonpulsatile perfusion mode at three flow rates (500,750, and 1000 mL/min) and with the purge line either open or closed. Six trials were performed for each unique set-up for a total of 36 trials.All trials were conducted at 35°C. The circuit pressure was kept constant at 100 mm Hg. Both the size and quantity of microemboli detected at postoxygenator site were recorded for 5 min postair injection. It was found that total counts of GME were significantly reduced with the purge line open when compared to keeping the purge line closed (P < 0.0001 at 1000 mL/min). At all flow rates, most of the GME were under 20 microns in size. In terms of microemboli greater than 40 microns, the counts were significantly higher with the purge line closed compared to keeping the purge line open at flow rates of 750 mL/min and 1000 mL/min (P < 0.01). At all flow rates,there is a tiny difference of less than 1 mmHg in membrane pressure drop between keeping the purge line open and closed, which is due to the small arteriovenous (A-V) shunt(P < 0.001). These results suggest that the integrated Arterial Filter of the Capiox FX05 oxygenator significantly improves the capturing of GME but has little impact on membrane pressure drop.
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evaluation of the quadrox i neonatal oxygenator with an integrated Arterial Filter
Perfusion, 2010Co-Authors: Arash Salavitabar, Feng Qiu, Allen R Kunselman, Akif ÜndarAbstract:Cardiopulmonary bypass (CPB) can be a potential cause of morbidity in patients for several reasons, including significantly higher gaseous microemboli (GME) formation than extracorporeal life support (ECLS) and physiological circulation, diverted blood flow from the patient via an open purge line of the Arterial Filter, and pressure drop across the oxygenator that is used in the circuit. Using a combined oxygenator and Arterial Filter may minimize these harmful factors and can effectively reduce the chances for postoperative morbidity. This study investigated the new QUADROX-i Neonatal Oxygenator (D-72145, Maquet, Hirrlingen, Germany) with an integrated Arterial Filter in terms of the hemodynamic properties and ability to clear GME in response to hypothermic versus normothermic conditions, open versus closed Arterial Filter purge line, and varying flow rates in a simulated CPB circuit identical to that of the clinical setting. A flow probe, pressure transducer, and Emboli Detection and Classification (EDA...