Pathophysiology and clinical implications of microbubbles during hemodialysis

Seminars in Dialysis

Volumn 21, Issue 3, 2008, Pages 232-238

  Barak, Michal ^b   Nakhoul, Farid ^b   Katz, Yeshayahu ^a,b  

^a Rambam Health Care Campus ^*  (Israel)

^b TECHNION ISRAEL INSTITUTE OF TECHNOLOGY   (Israel)

Author keywords

[No Author keywords available]

Indexed keywords

AIR EMBOLISM; BRAIN; CHRONIC KIDNEY FAILURE; HUMAN; LUNG; MICROBUBBLE; MICROCIRCULATION; PATHOPHYSIOLOGY; RENAL REPLACEMENT THERAPY; REVIEW;

BRAIN; EMBOLISM, AIR; HUMANS; KIDNEY FAILURE, CHRONIC; LUNG; MICROBUBBLES; MICROCIRCULATION; RENAL DIALYSIS;

EID: 44649124363     PISSN: 08940959     EISSN: 1525139X     Source Type: Journal    
DOI: 10.1111/j.1525-139X.2008.00424.x     Document Type: Review

References (94)

1. Denker BM, Chertow GM, Owen WF Jr. : Hemodialysis. In : The Kidney, 6th edn. Philadelphia : WB Saunders Company, 2000
2. Davenport A : Intradialytic complications during hemodialysis. Hemodial Int 10 : 162 167, 2006
3. Stegmayr CJ, Jonsson P, Forsberg U, Stegmayr BG : Development of air micro bubbles in the venous outlet line: an in vitro analysis of various air traps used for hemodialysis. Artif Organs 31 : 483 488, 2007
4. Stegmayr B, Forsberg U, Jonsson P, Stegmayr C : The sensor in the venous chamber does not prevent passage of air bubbles during hemodialysis. Artif Organs 31 : 162 166, 2007
5. Droste DW, Kuhne K, Schaefer RM, Bernd Ringelstein E : Detection of microemboli in the subclavian vein of patients undergoing haemodialysis and haemodiafiltration using pulsed Doppler ultrasound. Nephrol Dial Transplant 17 : 462 466, 2002
6. Rolle F, Pengloan J, Abazza M, Halimi JM, Laskar M, Pourcelot L, Tranquart F : Identification of microemboli during haemodialysis using Doppler ultrasound. Nephrol Dial Transplant 15 : 1420 1424, 2000
7. Gallagher EG, Pearson DT : Ultrasonic identification of sources of gaseous microemboli during open heart surgery. Thorax 28 : 295 305, 1973
8. Rodigas PC, Meyer FJ, Haasler GB, Dubroff JM, Spotnitz HM : Intraoperative 2-dimensional echocardiography: ejection of microbubbles from the left ventricle after cardiac surgery. Am J Cardiol 50 : 1130 1132, 1982
9. Hammon JW Jr., Edmunds LH Jr. : Extracorporeal circulation: organ damage. In : Cohn LH, Edmunds LH Jr. (eds). Cardiac Surgery in the Adult. New York : McGraw-Hill, 2003 : 361 388
10. Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S : The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 25 : 1393 1399, 1994
11. Murkin JM : Central nervous system dysfunction after cardiopulmonary bypass. In : Kaplan JA (ed). Cardiac Anesthesia. Philadelphia : WB Saunders Company, 1999 : 1259 1279
12. Roach GW, Kanchuger M, Mangano CM, Newman M, Nussmeier N, Wolman R, Aggarwal A, Marschall K, Graham SH, Ley C : Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med 335 : 1857 18563, 1996
13. McKhann GM, Borowicz LM, Goldsborough MA, Enger C, Selnes OA : Depression and cognitive decline after coronary artery bypass grafting. Lancet 349 : 1282 1284, 1997
14. Jones TJ, Deal DD, Vernon JC, Blackburn N, Stump DA : How effective are cardiopulmonary bypass circuits at removing gaseous microemboli? J Extra Corpor Technol 34 : 34 39, 2002
15. Mitsumaru A, Yozu R, Matayoshi T, Morita M, Shin H, Tsutsumi K, Iino Y, Kawada S : Efficiency of an air filter at the drainage site in a closed circuit with a centrifugal blood pump: an in vitro study. ASAIO J 47 : 692 695, 2001
16. Chang HK, Weber ME, Thomson J, Martin RR : Hydrodynamic features of pulmonary air embolism: a model study. J Appl Physiol 51 : 1002 1008, 1981
17. Souders JE, Doshier JB, Polissar NL, Hlastala MP : Spatial distribution of venous gas emboli in the lungs. J Appl Physiol 87 : 1937 1947, 1999
18. Srinivasan RS, Gerth WA, Powell MR : Mathematical model of diffusion-limited evolution of multiple gas bubbles in tissue. Ann Biomed Eng 31 : 471 481, 2003
19. Epstein PS, Plesset MS : On the stability of gas bubbles in liquid-gas solutions. J Chem Phys 18 : 1505 1509, 1950
20. Van Liew HD, Burkard ME : Bubbles in circulating blood: stabilization and simulations of cyclic changes of size and content. J Appl Physiol 79 : 1379 1385, 1995
21. Melamed Y, Shupak A, Bitterman H : Medical problems associated with underwater diving. N Eng J Med 326 : 30 35, 1992
22. Dexter F, Hindman BJ : Recommendations for hyperbaric oxygen therapy of cerebral air embolism based on a mathematical model of bubble absorption. Anesth Analg 84 : 1203 1207, 1997
23. Lango T, Morland T, Brubakk AO : Diffusion coefficients and solubility coefficients for gases in biological fluids and tissues: a review. Undersea Hyperb Med 23 : 247 272, 1996
24. Postema M, Bouakaz A, de Jong N : Noninvasive microbubble-based pressure measurements: a simulation study. Ultrasonics 42 : 759 762, 2004
25. Branger AB, Eckmann DM : Theoretical and experimental intravascular gas embolism absorption dynamics. J Appl Physiol 87 : 1287 1295, 1999
26. Philp RB, Inwood MJ, Warren BA : Interactions between gas bubbles and components of the blood: implications in decompression sickness. Aerosp Med 43 : 946 953, 1972
27. Kabalnov A, Klein D, Pelura T, Schutt E, Weers J : Dissolution of multicomponent microbubbles in the bloodstream: 1. Theory. Ultrasound Med Biol 24 : 739 749, 1998
28. Cavanagh DP, Eckmann DM : The effect of soluble surfactant on the interfacial dynamics of stationary bubbles in inclined tubes. J Fluid Mech 469 : 369 400, 2002
29. Suzuki A, Armstead SC, Eckmann DM : Surfactant reduction in embolism bubble adhesion and endothelial damage. Anesthesiology 101 : 97 103, 2004
30. Eckmann DM, Armstead SC : Influence of endothelial glycocalyx degradation and surfactants on air embolism adhesion. Anesthesiology 105 : 1220 1227, 2006
31. Lindner JR, Ismail S, Spotnitz WD, Skyba DM, Jayaweera AR, Kaul S : Albumin microbubble persistence during myocardial contrast echocardiography is associated with microvascular endothelial glycocalyx damage. Circulation 98 : 2187 2194, 1998
32. Suzuki A, Eckmann DM : Embolism bubble adhesion force in excised perfused microvessels. Anesthesiology 99 : 400 408, 2003
33. Kobayashi N, Yasu T, Yamada S, Kudo N, Kuroki M, Kawakami M, Miyatake K, Saito M : Endothelial cell injury in venule and capillary induced by contrast ultrasonography. Ultrasound Med Biol 28 : 949 956, 2002
34. Ohkuda K, Nakahara K, Binder A, Staub NC : Venous air emboli in sheep: reversible increase in lung microvascular permeability. J Appl Physiol 51 : 887 894, 1981
35. Flick MR, Perel A, Staub NC : Leukocytes are required for increased lung microvascular permeability after microembolization in sheep. Circ Res 48 : 344 351, 1981
36. Ward CA, Koheil A, McCullough D, Johnson WR, Fraser WD : Activation of complement at plasma-air or serum-air interface of rabbits. J Appl Physiol 60 : 1651 1658, 1986
37. Lindner JR, Coggins MP, Kaul S, Klibanov AL, Brandenburger GH, Ley K : Microbubble persistence in the microcirculation during ischemia/reperfusion and inflammation is caused by integrin- and complement-mediated adherence to activated leukocytes. Circulation 101 : 668 675, 2000
38. Huang KL, Lin YC : Activation of complement and neutrophils increases vascular permeability during air embolism. Aviat Space Environ Med 68 : 300 305, 1997
39. Nossum V, Hjelde A, Bergh K, Ustad AL, Brubakk AO : Anti-C5a monoclonal antibodies and pulmonary polymorphonuclear leukocyte infiltration - endothelial dysfunction by venous gas embolism. Eur J Appl Physiol 89 : 243 248, 2003
40. Eckmann DM, Diamond SL : Surfactants attenuate gas embolism-induced thrombin production. Anesthesiology 100 : 77 84, 2004
41. Thorsen T, Klausen H, Lie RT, Holmsen H : Bubble-induced aggregation of platelets: effects of gas species, proteins, and decompression. Undersea Hyperb Med 20 : 101 119, 1993
42. Tachibana K, Tachibana S : Albumin microbubble echo-contrast material as an enhancer for ultrasound accelerated thrombolysis. Circulation 92 : 1148 1150, 1995
43. Ritz-Timme S, Eckelt N, Schmidtke E, Thomsen H : Genesis and diagnostic value of leukocyte and platelet accumulations around "air bubbles" in blood after venous air embolism. Int J Legal Med 111 : 22 26, 1998
44. Ryu KH, Hindman BJ, Reasoner DK, Dexter F : Heparin reduces neurological impairment after cerebral arterial air embolism in the rabbit. Stroke 27 : 303 310, 1996
45. Bischel MD, Scoles BG, Mohler JG : Evidence for pulmonary microembolization during hemodialysis. Chest 67 : 335 337, 1975
46. Woltmann D, Fatica RA, Rubin JM, Weitzel W : Ultrasound detection of microembolic signals in hemodialysis access. Am J Kidney Dis 35 : 328 526, 2000
47. Droste DW, Benya T, Frye B, Schulte V, Bernd Ringelstein E, Schaefer RM : Reduction of circulating microemboli in the subclavian vein of patients undergoing haemodialysis using pre-filled instead of dry dialysers. Nephrol Dial Transplant 18 : 2377 2381, 2003
48. Polaschegg HD. Hemodialysis machine air detectors need not detect microbubbles. Artif Organs 2007 31 : 911 912 author reply 913-4
49. Jonsson P, Karlsson L, Forsberg U, Gref M, Stegmayr C, Stegmayr B : Air bubbles pass the security system of the dialysis device without alarming. Artif Organs 31 : 132 139, 2007
50. The FDA Enforcement Report, June 17 1992, Alert #M-060-2. COBE Centry System. http://www.fda.gov/bbs/topics/ENFORCE/ENF00151.html
51. The FDA Enforcement Report, April 7 2004, 04-14, Baxter Meridian Hemodialysis Instrument, product codes 5M5576 and 5M5576R. Recall # Z-0758-04. http//: http://www.fda.gov/bbs/topics/enforce/2004/ENF00842.html
52. Nielsen AL, Jensen HA, Hegbrant J, Brinkenfeldt H, Thunedborg P : Oxygen status during haemodialysis: the cord group. Acta Anaesthesiol Scand Suppl 107 : 195 200, 1995
53. De Broe ME, Heyrman RM, De Backer WA, Verpooten GA, Vermeire PA : Pathogenesis of dialysis-induced hypoxemia: a short overview. Kidney Int Suppl 24 : S57 S61, 1988
54. Fairshter RD, Vaziri ND, Mirahmadi MK : Lung pathology in chronic hemodialysis patients. Int J Artif Organs 5 : 97 100, 1982
55. Coskun M, Boyvat F, Bozkurt B, Agildere M, Niron EA : Thoracic CT findings in long-term hemodialysis patients. Acta Radiol 40 : 181 186, 1998
56. Haque AK, Rubin SA, Leveque CM : Pulmonary calcification in long-term hemodialysis: a mimic of pulmonary throbmoembolism. Am J Nephrol 4 : 109 113, 1984
57. Albertine KH, Wiener-Kronish JP, Koike K, Staub NC : Quantification of damage by air emboli to lung microvessels in anesthetized sheep. J Appl Physiol 57 : 1360 1368, 1984
58. Gilbert JW Jr., Berglund E, Dahlgren S, Ovenfors CO, Barnes R : Experimental pulmonary hypertension in the dog. A preparation involving repeated air embolism. J Thorac Cardiovasc Surg 55 : 565 571, 1968
59. Perkett EA, Brigham KL, Meyrick B : Continous air embolization into sheep causes sustained pulmonary hypertension and increased pulmonary vasoreactivity. Am J Pathol 132 : 444 454, 1988
60. Amin M, Fawzy A, Hamid MA, Elhendy A : Pulmonary hypertension in patients with chronic renal failure: role of parathyroid hormone and pulmonary artery calcifications. Chest 24 : 2093 2097, 2003
61. Yigla M, Nakhoul F, Sabag A, Tov N, Gorevich B, Abassi Z, Reisner SA : Pulmonary hypertension in patients with end-stage renal disease. Chest 123 : 1577 1582, 2003
62. Nakhoul F, Yigla M, Gilman R, Reisner SA, Abassi Z : The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access. Nephrol Dial Transplant 20 : 1686 1692, 2005
63. Abassi Z, Nakhoul F, Khankin E, Reisner SA, Yigla M : Pulmonary hypertension in chronic dialysis patients with arteriovenous fistula: pathogenesis and therapeutic prospective. Curr Opin Nephrol Hypertens 15 : 353 360, 2006
64. Brouns R, De Deyn PP : Neurological complications in renal failure: a review. Clin Neurol Neurosurg 107 : 1 16, 2004
65. Madero M, Gul A, Sarnak MJ : Cognitive function in chronic kidney disease. Semin Dial 21 : 29 37, 2008
66. Murray AM, Pederson SL, Tupper DE, Hochhalter AK, Miller WA, Li Q, Zaun D, Collins AJ, Kane R, Foley RN : Acute variation in cognitive function in hemodialysis patients: a cohort study with repeated measures. Am J Kidney Dis 50 : 270 278, 2007
67. Savazzi GM, Cusmano F, Vinci S, Allegri L : Progression of cerebral atrophy in patients on hemodialysis treatment. Long-term follow-up with cerebral computed tomography. Nephron 69 : 29 33, 1995
68. Kamata T, Hishida A, Takita T, Sawada K, Ikegaya N, Meruyama Y, Miyajima H, Kaneko E : Morphologic abnormalities in the brain of chronically hemodialyzed patients without cerebrovascular disease. Am J Nephrol 20 : 27 31, 2000
69. Pereira AA, Weiner DE, Scott T, Sarnak MJ : Cognitive function in dialysis patients. Am J Kidney Dis 45 : 448 462, 2005
70. Rakowski DA, Caillard S, Agodoa LY, Abbott KC : Dementia as a predictor of mortality in dialysis patients. Clin J Am Soc Nephrol 1 : 1000 1005, 2006
71. Rob PM, Niederstadt C, Reusche E : Dementia in patients undergoing long-term dialysis: aetiology, differential diagnoses, epidemiology and management. CNS Drugs 15 : 691 699, 2001
72. Lynch JJ, Schuchard GH, Gross CM, Wann LS : Prevalence of right-to-left atrial shunting in a healthy population: detection by Valsalva maneuver contrast echocardiography. Am J Cardiol 53 : 1478 1480, 1984
73. Droste DW, Reisener M, Kemény V, Dittrich R, Schulte-Altedorneburg G, Stypmann J, Wichter T, Ringelstein EB : Contrast transcranial Doppler ultrasound in the detection of right-to-left shunts: reproducibility, comparison of two agents and distribution of microemboli. Stroke 30 : 1014 1018, 1999
74. Foster PP, Boriek AM, Butler BD, Gernhardt ML, Bove AA : Patent foramen ovale and paradoxical systemic embolism: a bibliographic review. Aviat Space Environ Med 74 : B1 B64, 2003
75. Yu AS, Levy E : Paradoxical cerebral air embolism from a hemodialysis catheter. Am J Kidney Dis 29 : 453 455, 1997
76. Butler BD, Hills BA : The lung as a filter for microbubbles. J Appl Physiol 47 : 537 543, 1979
77. Butler BD, Hills BA : Transpulmonary passage of venous air emboli. J Appl Physiol 59 : 543 547, 1985
78. Butler BD, Robinson R, Sutton T, Kemper GB : Cardiovascular pressures with venous gas embolism and decompression. Aviat Space Environ Med 66 : 408 414, 1995
79. Palanchon P, Bouakaz A, van Blankenstein JH, Klein J, Bom N, de Jong N : New technique for emboli detection and discrimination based on nonlinear characteristics of gas bubbles. Ultrasound Med Biol 27 : 801 808, 2001
80. Palanchon P, Bouakaz A, Klein J, De Jong N : Subharmonic and ultraharmonic emissions for emboli detection and characterization. Ultrasound Med Biol 29 : 417 425, 2003
81. Palanchon P, Birmelé B, Tranquart F : Acoustical bubble trapper applied to hemodialysis. Ultrasound Med Biol, 2007, Nov 7 [Epub ahead of print]
82. Schwarz KQ, Church CC, Serrino P, Meltzer RS : The acoustic filter: an ultrasonic blood filter for the heart-lung machine. J Thorac Cardiovasc Surg 104 : 1647 1653, 1992
83. Perthel M, Kseibi S, Bendisch A, Laas J : Use of a dynamic bubble trap in the arterial line reduces microbubbles during cardiopulmonary bypass and microembolic signals in the middle cerebral artery. Perfusion 20 : 151 156, 2005
84. Muth CM, Shank ES : Gas embolism. N Engl J Med 342 : 476 482, 2000
85. Moon RE, de Lisle Dear G, Stolp BW : Treatment of decompression illness and iatrogenic gas embolism. Respir Care Clin N Am 5 : 93 135, 1999
86. Benson J, Adkinson C, Collier R : Hyperbaric oxygen therapy of iatrogenic cerebral arterial gas embolism. Undersea Hyperb Med 30 : 117 126, 2003
87. Murphy BP, Harford FJ, Cramer FS : Cerebral air embolism resulting from invasive medical procedures. Treatment with hyperbaric oxygen. Ann Surg 201 : 242 245, 1985
88. Kol S, Ammar R, Weisz G, Melamed Y : Hyperbaric oxygenation for arterial air embolism during cardiopulmonary bypass. Ann Thorac Surg 55 : 401 403, 1993
89. Blanc P, Boussuges A, Henriette K, Sainty JM, Deleflie M : Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med 28 : 559 563, 2002
90. van Hulst RA, Klein J, Lachmann B : Gas embolism: pathophysiology and treatment. Clin Physiol Funct Imaging 23 : 237 246, 2003
91. Dutka AJ, Mink RB, Pearson RR, Hallenbeck JM : Effects of treatment with dexamethasone on recovery from experimental cerebral arterial gas embolism. Undersea Biomed Res 19 : 131 141, 1992
92. Dutka AJ, Mink R, McDermott J, Clark JB, Hallenbeck JM : Effect of lidocaine on somatosensory evoked response and cerebral blood flow after canine cerebral air embolism. Stroke 23 : 1515 1520, 1992
93. Cochran RP, Kunzelman KS, Vocelka CR, Akimoto H, Thomas R, Soltow LO, Spiess BD : Perfluorocarbon emulsion in the cardiopulmonary bypass prime reduces neurologic injury. Ann Thorac Surg 63 : 1326 1332, 1997
94. Svitova TF, Wetherbee MJ, Radke CJ : Dynamics of surfactant sorption at the air/water interface: continuous flow tensiometry. J Colloid Interface Sci 261 : 170 179, 2003