• Inger M Husebråten, Arnt E Fiane, Mari-Anne I L Ringdal, and Amrit P S Thiara.
• Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
• Perfusion. 2018 Jan 1; 33 (1): 30-35.

IntroductionThe use of cardiopulmonary bypass is associated with a risk of neurocognitive deficit caused by gaseous microemboli. Flushing the empty bypass circuit with carbon dioxide, which is more soluble than air, may reduce the amount of gaseous microemboli in the priming solution before the initiating of cardiopulmonary bypass.MethodWe measured the amount of gaseous microemboli in twenty primed bypass circuits. Ten circuits were flushed with carbon dioxide before being primed and ten circuits were non-flushed. All circuits in both groups were primed with crystalloid priming. An ultrasonic clinical bubble counter was used to count gaseous microemboli in the prime for 20 minutes.ResultsThe median numbers of gaseous microemboli counts were highest during the first minute in both groups, with a significantly lower median value in the group flushed with carbon dioxide (397.5) versus the non-flushed group (1900). In the 20th minute, the median values of gaseous microemboli were significantly lower (p<0.023) in the flushed (0.5) versus non-flushed (10.75) groups. The gaseous microembolic count in the flushed group remained lower than in the non-flushed group when tested minute by minute throughout the whole 20-minute period.ConclusionFlushing the bypass circuits with carbon dioxide before priming significantly decreased the number of gaseous microemboli in the priming solution.

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