Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen
<i>Background and Objectives:</i> This study aimed to investigate the risk and mechanisms of air entry into the extracorporeal membrane oxygenation (ECMO) circuit through the central venous catheter (CVC) in a veno-venous configuration. The primary goal was to assess the impact of differ...
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2024-11-01
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| Online Access: | https://www.mdpi.com/1648-9144/60/11/1883 |
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| author | Danilo Franco Nejc Krasna Robert Novak Giovanni Esposito Raffaele Izzo Jan Belohlavek Marko Noc Tomaz Goslar |
| author_facet | Danilo Franco Nejc Krasna Robert Novak Giovanni Esposito Raffaele Izzo Jan Belohlavek Marko Noc Tomaz Goslar |
| author_sort | Danilo Franco |
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| description | <i>Background and Objectives:</i> This study aimed to investigate the risk and mechanisms of air entry into the extracorporeal membrane oxygenation (ECMO) circuit through the central venous catheter (CVC) in a veno-venous configuration. The primary goal was to assess the impact of different air volumes on ECMO circuit performance at varying pump speeds. <i>Material and Methods:</i> The study utilized a circuit model to simulate ECMO conditions and evaluate the potential entry points of air, specifically through the unprotected lumen of the CVC. Various interventions, such as the use of a closed three-way stopcock or clave, were implemented to assess their efficacy in preventing air entry. <i>Results:</i> The unprotected lumen of the central venous catheter posed a significant risk for air entry into the ECMO circuit. The introduction of a closed three-way stopcock or clave proved effective in preventing air ingress through the central venous catheter. Auditory cues, such as a distinct hissing sound, served as an early warning sign of air presence in the circuit. The study demonstrated that even small volumes of air, as minimal as 1 mL, could pass through the oxygenator at specific pump speeds, and larger volumes could lead to pump dysfunction. <i>Conclusions:</i> The study identified the unprotected lumen of the central venous catheter as a potential entry point for air into the ECMO circuit. The use of a closed three-way stopcock or one-way valve was found to be a reliable protective measure against air infiltration. Early detection through the observation of a hissing sound in the circuit provided a valuable warning sign. These findings contribute to enhancing the safety and performance of ECMO systems by minimizing the risk of air embolism. |
| format | Article |
| id | doaj-art-cc83fe240b19472f90633edbe3e643cf |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-cc83fe240b19472f90633edbe3e643cf2024-11-26T18:12:48ZengMDPI AGMedicina1010-660X1648-91442024-11-016011188310.3390/medicina60111883Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter LumenDanilo Franco0Nejc Krasna1Robert Novak2Giovanni Esposito3Raffaele Izzo4Jan Belohlavek5Marko Noc6Tomaz Goslar7Center for Intensive Internal Medicine, University Medical Center, Zaloska 7, 1000 Ljubljana, SloveniaEmergency Center, General Hospital Celje, Oblakova 5, 3000 Celje, SloveniaDepartment of Cardiovascular Surgery, University Medical Center, Zaloska 7, 1000 Ljubljana, SloveniaDepartment of Advance Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples, ItalyDepartment of Advance Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples, Italy2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital, 10000 Prague, Czech RepublicCenter for Intensive Internal Medicine, University Medical Center, Zaloska 7, 1000 Ljubljana, SloveniaCenter for Intensive Internal Medicine, University Medical Center, Zaloska 7, 1000 Ljubljana, Slovenia<i>Background and Objectives:</i> This study aimed to investigate the risk and mechanisms of air entry into the extracorporeal membrane oxygenation (ECMO) circuit through the central venous catheter (CVC) in a veno-venous configuration. The primary goal was to assess the impact of different air volumes on ECMO circuit performance at varying pump speeds. <i>Material and Methods:</i> The study utilized a circuit model to simulate ECMO conditions and evaluate the potential entry points of air, specifically through the unprotected lumen of the CVC. Various interventions, such as the use of a closed three-way stopcock or clave, were implemented to assess their efficacy in preventing air entry. <i>Results:</i> The unprotected lumen of the central venous catheter posed a significant risk for air entry into the ECMO circuit. The introduction of a closed three-way stopcock or clave proved effective in preventing air ingress through the central venous catheter. Auditory cues, such as a distinct hissing sound, served as an early warning sign of air presence in the circuit. The study demonstrated that even small volumes of air, as minimal as 1 mL, could pass through the oxygenator at specific pump speeds, and larger volumes could lead to pump dysfunction. <i>Conclusions:</i> The study identified the unprotected lumen of the central venous catheter as a potential entry point for air into the ECMO circuit. The use of a closed three-way stopcock or one-way valve was found to be a reliable protective measure against air infiltration. Early detection through the observation of a hissing sound in the circuit provided a valuable warning sign. These findings contribute to enhancing the safety and performance of ECMO systems by minimizing the risk of air embolism.https://www.mdpi.com/1648-9144/60/11/1883extracorporeal membrane oxygenationair embolismcomplicationssimulation |
| spellingShingle | Danilo Franco Nejc Krasna Robert Novak Giovanni Esposito Raffaele Izzo Jan Belohlavek Marko Noc Tomaz Goslar Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen Medicina extracorporeal membrane oxygenation air embolism complications simulation |
| title | Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen |
| title_full | Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen |
| title_fullStr | Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen |
| title_full_unstemmed | Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen |
| title_short | Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen |
| title_sort | prevention of air embolism in extracorporeal membrane oxygenation systems an in vitro study on protection of central venous catheter lumen |
| topic | extracorporeal membrane oxygenation air embolism complications simulation |
| url | https://www.mdpi.com/1648-9144/60/11/1883 |
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