Understanding the Impact of Synthetic Hematocrit Levels and Biomimetic Channel Widths on Bubble Parameters in...

Gas embolism is a rare but life-threatening process characterized by the presence of gas bubbles in the venous or arterial systems. These bubbles, if sufficiently large or numerous, can block the delivery of oxygen to critical organs, in particular the brain, and subsequently they can trigger a cascade of adverse biochemical reactions with severe medical outcomes. Despite its critical nature, gas embolism remains poorly understood, necessitating extensive investigation, particularly regarding its manifestations in the human body and its modulation by various biological conditions. However, given its elusive nature, as well as potential lethality, gas embolism is extremely difficult to study in vivo, and nearly impossible to be the subject of clinical trials. To this end, we developed a microfluidic device designed to study in vitro the impact of blood properties and vascular geometries on the formation and evolution of gas bubbles. The system features a biomimetic vascular channel surrounded by two pressure chambers, which induce the genesis of bubbles under varying circumstances. The bubble parameters were correlated with different input parameters, i.e., channel widths, wall thicknesses, viscosities of the artificial blood, and pressure levels. Smaller channel widths and higher equivalent hematocrit concentrations in synthetic blood solutions increased the nucleation density and bubble generation frequencies. Small channel widths were also more prone to bubble formation, with implications for the vulnerability of vascular walls, leading to increased risks of damage or compromise to the integrity of the blood vessels. Larger channel widths, along with higher equivalent hematocrit concentrations, translated into larger bubble volumes and decreased bubble velocities, leading to an increased risk of bubble immobilization within the blood vessels. This biomimetic approach provides insights into the impact of patient history and biological factors on the incidence and progression of gas embolism. Medical conditions, such as anemia, along with anatomical features related to age and sex-such as smaller blood vessels in women and children or larger vascular widths in adult men-affect the susceptibility to the initiation and progression of gas embolism, explored here in vitro through the development of a controlled, physiological-like environment. The analysis of the videos that recorded gas embolism events in vitro for systems where pressure is applied laterally on the microvasculature with thin walls, i.e., 50 μm or less, suggests that the mechanism of gas transfer for the pressure area to the blood is based on percolation, rather than diffusion. These findings highlight the importance of personalized approaches in the management and prevention of gas embolism.