体外循环动脉微栓过滤器性能离体实验研究

目的:通过离体实验评价成人型动脉滤器(QUART)、米道斯动脉滤器(MEDOS)和宁波动脉微栓滤器的跨滤器压差和气泡去除能力。方法:分别选用QUART、MEDOS和宁波3种动脉过滤器各15个,依次为QG组、MG组和NG组,连接模拟体外循环管路,使用1 000 mL0.9%氯化钠预充环路,并在管路上连接Stockert气泡捕捉器。同时在动脉滤器的入口端、出口端和排气管处连接电子测压仪,使用管钳维持动脉滤器出口处压力为80 mmHg(1 mmHg=0.133 kPa),测定动脉滤器入口端、出口端和排气管处的压力。在流量为5.0 L/min时,于动脉滤器入口处每隔1 min加入10 mL空气,最多不超过80mL。结果:预充后NG组中9个(9/15,60.0%)动脉微栓滤器发出报警音,明显高于QG组和MG组,差异具有统计学意义(P<0.05);首次倒排时,QG、MG和NG组分别有1/15(6.7%)、13/15(86.7%)和15/15(100.0%)发出报警音,QG组明显低于MG组和NG组,差异具有统计学意义(P<0.05)。随着主泵流量的增加,3种动脉滤器入口端压力、出口端压力及压差均逐渐升高。相同流量下,3种动脉滤器入口端压力、出口端压力和压差差异均无统计学意义(P>0.05);流量为5 L/min,3组动脉滤器分别加入气体至80 mL时均未发出报警音。结论:使用动脉滤器时,排气需要2遍以上,才能安全使用。正常转机流量下,3种动脉滤器跨滤器压差基本相同。3种动脉滤器均有较强的气泡隔离能力。

Comparison of three different arterial filters on the pressure drop and the capability of trapping gaseous microemboli in a in vitro model

Objective:The purpose of this study was undertaken to compare three different arterial filters(QUART,MEDOS,and Fly) on the pressure drop and the delivery of gaseous micro-emboli in a in vitro model.Methods: The fifteen circuits were respectively assembled with QUART(QG,n=15),MEDOS(MG,n=15),and Fly(NG,n=15) artery filters.The circuit was primed with 1 000 mL physiological saline and the post-filter pressure was maintained at 80 mmHg(1 mmHg=0.133 kPa) using a Hoffman clamp.The arterial filter purge line was kept open during all trials.The pressure drop through the filter was monitored at flow rates of from 1 to 5 L/min(1L/min increments).A Doppler ultrasound(Stockert) was positioned downstream on the arterial line to detect gaseous microemboli.When flow rate was 5 L/min,the arterial filters were challenged with upstream injections of boluses of air of 10 mL every 1 minutes,but the totally volume of air not over 80 mL.Results: Compared with QUART and MEDOS arterial filters,the rate of Fly arterial filter takes out of alarm sounds more at priming(P<0.05).At firstly de-airing,there are shows less alarm sounds in QUART arterial filter than MEDOS and Fly arterial fliters(P<0.05).With the flow rate increases,the inlet pressure and outlet pressures,as well as pressure drop through the filter also increase.There were no statistically significant differences among the three groups in the inlet pressures,outlet pressures,as well as pressure drop through filter at the same flow rate(P>0.05).No any alarm sound was shown among three kinds of artery filters after injection of 80 mL air at the flow 5 L/min.Conclusion: Artery filter is used through over twice de-airing.The results of pressure drop at normal cardiopulmonary bypass flow show that three kinds of artery filters are well within the acceptable range.This study shows that three kinds of artery filters offers good air filtering capacity after injection of large boluses of air.