Related Experiment Video
Updated: May 10, 2026
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Microemboli detection and classification during pediatric cardiopulmonary bypass
Joseph B Clark1, Feng Qiu, Yulong Guan
1Department of Pediatrics, Penn State Hershey, Hershey, Pennsylvania.
Abstract:
Microemboli may be a cause of postoperative neurological morbidity. Improved detection of microemboli may lead to better strategies to minimize embolization and improve neurological outcomes. Transcranial Doppler may have limited sensitivity for very small microemboli. The Emboli Detection and Classification (EDAC) Quantifier offers increased sensitivity (10 μm) and potentially improved capability for microemboli monitoring. EDAC was used to measure microemboli in the cardiopulmonary bypass circuit during 33 pediatric heart operations. More microemboli were detected in the venous than the arterial line (median, 11,830 vs 1298). Venous microemboli tended to be larger in size than arterial microemboli (>40 μm; 59% vs 7%). Increased venous and arterial microemboli were seen at the onset of bypass; increased venous microemboli were also seen with clamp removal. Thousands of microemboli <40 μm are transmitted to pediatric patients during heart surgery. Initiation of bypass may be a key offender and may result from air in the venous line. Although the significance of microemboli remains unknown, increased awareness may lead to improved techniques to minimize microemboli, with improvement in neurological outcomes.
Insights
New Emboli Detection and Classification (EDAC) Quantifier technology improved microemboli detection during pediatric heart surgery. This enhanced monitoring may lead to strategies that reduce neurological complications.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Biomedical Engineering
Background:
- Postoperative neurological morbidity is a concern in cardiac surgery.
- Transcranial Doppler has limitations in detecting small microemboli.
- Improved microemboli detection could enhance patient outcomes.
Purpose of the Study:
- To evaluate the Emboli Detection and Classification (EDAC) Quantifier for microemboli monitoring.
- To assess microemboli presence and characteristics in pediatric cardiopulmonary bypass circuits.
- To identify potential sources and timing of microemboli generation.
Main Methods:
- Utilized the Emboli Detection and Classification (EDAC) Quantifier.
- Monitored microemboli in the cardiopulmonary bypass circuit during 33 pediatric heart operations.
- Analyzed microemboli quantity, size, and location (venous vs. arterial lines).
Main Results:
- Significantly more microemboli detected in the venous line (median 11,830) compared to the arterial line (1298).
- Venous microemboli were larger (>40 μm) in 59% of cases, versus 7% in arterial lines.
- Increased microemboli counts observed at bypass onset and with clamp removal; venous lines showed higher counts.
Conclusions:
- The EDAC Quantifier offers enhanced sensitivity for microemboli detection (10 μm).
- Thousands of microemboli, many <40 μm, are transmitted to pediatric patients during heart surgery.
- Initiation of bypass, potentially due to venous line air, may be a significant source of microemboli, warranting further investigation to improve neurological outcomes.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:29Pulmonary Embolism I: Introduction
01:19Pulmonary Embolism I: Introduction
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...