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[Gas embolisms during operations on the open heart]
Fortschritte Der Medizin
|February 24, 1983
Summary
Microbubbles released during open heart surgery can cause cerebral cell injury, especially after cardiotomy. Carbon dioxide wash-out may mitigate this risk by reducing enzyme levels in cerebrospinal fluid.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Biomedical Engineering
Context:
- Open heart procedures involve extracorporeal circulation (ECC), which can generate microbubbles.
- These microbubbles can enter arterial circulation, potentially reaching the brain.
- The impact of cardiac-derived microbubbles on cerebral injury requires further investigation.
Purpose:
- To quantify microbubble activity in arterial circulation during open heart surgery.
- To investigate the link between microbubbles and cerebral cell injury using an experimental model.
- To evaluate the efficacy of filters and CO2 wash-out in mitigating microbubble-related risks.
Summary:
- Ultrasonic probes measured microbubble levels in the arterial line and carotid artery during open heart surgery.
- Bubble activity peaked during bypass initiation and reperfusion, with higher levels in the carotid artery after cardiotomy.
- Cerebrospinal fluid enzyme levels increased significantly after cardiotomy but were reduced by CO2 wash-out; filters had limited impact during reperfusion.
Impact:
- Findings highlight the risk of cerebral microembolism during open heart surgery, particularly post-cardiotomy.
- CO2 wash-out shows promise in reducing neurological injury markers.
- This research informs strategies for minimizing microbubble-induced complications in cardiac procedures.