Marco C Stehouwer

Publications (3)7.46 Total impact

• Article: Clinical evaluation of the air removal characteristics of an oxygenator with integrated arterial filter in a minimized extracorporeal circuit.

  Marco C Stehouwer, Chris Boers, Roel de Vroege, Johannes C Kelder, Alaaddin Yilmaz, Peter Bruins
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  ABSTRACT: The use of minimized extracorporeal circuits (MECC) in cardiac surgery is an important measure to increase the biocompatibility of cardiopulmonary bypass during coronary artery bypass grafting (CABG). These circuits eliminate volume storage reservoirs and bubble traps to minimize the circuit. However, the reduction in volume may increase the risk of gaseous microemboli (GME). The MECC system as used by our group consists of a venous bubble trap, centrifugal pump, and an oxygenator. To further reduce the risk of introducing GME, an oxygenator with an integrated arterial filter was developed based on the concept of minimal volume and foreign surface. We studied the air removal characteristics of this oxygenator with and without integrated arterial filter. The quantity and volume of GME were measured with precision at both the inlet and outlet of the devices. Our results showed that integration of an arterial filter into this oxygenator increased GME reducing capacity from 69.2% to 92%. Moreover, we were able to obtain data on the impact of an arterial filter on the exact size-distribution of GME entering the arterial line. The present study demonstrates that an MECC system and oxygenator with integrated arterial filter significantly reduces the volume and size of GME. The use of an integrated arterial filter in an MECC system may protect the patient from the deleterious effects of CPB and may further improve patient safety.
  The International journal of artificial organs 04/2011; 34(4):374-82. · 1.86 Impact Factor
• Article: Air removal efficiency of a venous bubble trap in a minimal extracorporeal circuit during coronary artery bypass grafting.

  Tamara P A Roosenhoff, Marco C Stehouwer, Roel De Vroege, René P Butter, Wim-Jan Van Boven, Peter Bruins
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  ABSTRACT: The use of minimized extracorporeal circuits (MECC) in cardiac surgery is expanding. These circuits eliminate volume storage and bubble trap reservoirs to minimize the circuit. However, this may increase the risk of gaseous micro emboli (GME). To reduce this risk, a venous bubble trap was designed. This study was performed to evaluate if incorporation of a venous bubble trap in a MECC system as compared to our standard minimized extracorporeal circuit without venous bubble trap reduces gaseous micro emboli during cardiopulmonary bypass (CPB). Forty patients were randomly assigned to be perfused either with or without an integrated venous bubble trap. After preliminary evaluation of the data of 23 patients, the study was terminated prior to study completion. The quantity and volume of GME were significantly lower in patients perfused with a venous bubble trap compared to patients perfused without a venous bubble trap. The present study demonstrates that a MECC system with a venous bubble trap significantly reduces the volume of GME and strongly reduces the quantity of large GME (>500 µm). Therefore, the use of a venous bubble trap in a MECC system is warranted.
  Artificial Organs 12/2010; 34(12):1092-8. · 2.00 Impact Factor
• Source

  Available from: Peter Bruins

  Article: Imaging the human microcirculation during cardiopulmonary resuscitation in a hypothermic victim of submersion trauma.

  Paul W G Elbers, Antonius J Craenen, Antoine Driessen, Marco C Stehouwer, Luuk Munsterman, Miranda Prins, Mat van Iterson, Peter Bruins, Can Ince
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  ABSTRACT: The microcirculation is essential for delivery of oxygen and nutrients to tissue. However, the human microvascular response to cardiopulmonary resuscitation (CPR) is unknown. We report on the first use of sidestream dark field imaging to assess the human microcirculation during CPR with a mechanical chest compression/decompression device (mCPR). mCPR was able to provide microvascular perfusion. Capillary flow persisted even during brief mCPR interruption. However, indices of microvascular perfusion were low and improved vastly after return of spontaneous circulation. Microvascular perfusion was relatively independent from blood pressure. The microcirculation may be a useful monitor for determining the adequacy of CPR.
  Resuscitation 12/2009; 81(1):123-5. · 3.60 Impact Factor