Elimination of microbubbles from the extracorporeal circuit: dynamic bubble trap versus arterial filter

BACKGROUND

Open heart surgery is associated with important risk of cerebral and peripheral organ dysfunction, attributed in part to microbubbles generated in or not eliminated from the ECC. For elimination of microbubbles, a dynamic bubble trap (DBT) was developed for the arterial line of ECCs.

METHODS

Bubble eliminating properties of an arterial filter were evaluated in four CABG patients and compared to the performance of the DBT in four patients. One patient received both devices.

RESULTS

Elimination of bubbles between 40-120 microm was significantly higher with the DBT (88% vs. 57% with arterial filter, p=0.034). Reduction of bubbles below 40 microm was equivalent in both groups. The combination of both devices was most effective (94% for bubbles >40 microm).

CONCLUSION

Arterial filter and DBT are equally effective in elimination of smaller gas bubbles. However, bigger bubbles possibly causing cerebral and peripheral organ damage are eliminated to a greater degree by the DBT.

Laboratory outreach: student assessment of flow cytometer fluidics in zero gravity

Due to the the clinical utility of the flow cytometer, the National Aeronautics and Space Administration (NASA) is interested in the design of a space flight-compatible cytometer for use on long-duration space missions. Because fluid behavior is altered dramatically during space flight, it was deemed necessary to validate the principles of hydrodynamic focusing and laminar flow (cytometer fluidics) in a true microgravity environment. An experiment to validate these properties was conducted by 12 students from Sweetwater High School (Sweetwater, TX) participating in the NASA Reduced Gravity Student Flight Opportunity, Class of 2000. This program allows high school students to gain scientific experience by conducting an experiment on the NASA KC-135 zero gravity laboratory aircraft. The KC-135 creates actual zero-gravity conditions in 30-second intervals by flying a highly inclined parabolic flight path. The experiment was designed by their mentor in the program, the Johnson Space Center's flow cytometrist Brian Crucian, PhD, MT(ASCP). The students performed the experiment, with the mentor, onboard the NASA zero-gravity research aircraft in April 2000.

Size discrepancy between somatomedin-C and insulin receptors

Somatomedin-C (Sm-C) and insulin receptors have similar size and structure. Each receptor is a heterotetramer composed two alpha- and two beta-subunits. Sodium dodecyl sulfate (SDS)-polyacrylamide gel autoradiographic studies of affinity labeled receptor preparations demonstrated that each has a whole receptor of greater than 350,000 daltons, a half-receptor of 220,000 daltons, and binding subunit (alpha-subunit) of about 140,000 daltons. Using SDS-polyacrylamide disc gels and double labeling techniques, we demonstrated that the 125I affinity labeled alpha-subunit of the Sm-C receptor from human placenta was 8,000 daltons smaller than the 131I affinity labeled insulin receptor alpha-subunit. Further double label studies demonstrated that [125I]insulin and [131I]insulin cross-linked to placental insulin receptors precisely comigrated on SDS-disc gels, indicating that the difference between insulin and Sm-C alpha-subunits is not an artifact of the system. The difference in ligand size (Sm-C, 7,500 daltons; insulin, 5,700 daltons) would minimize the observed difference and is clearly not the cause of the difference in size observed. These studies provide further evidence in support of two functionally and physically distinct receptor molecules for insulin and Sm-C in human placenta.