Scanning electron microscopic analysis of arterial line filters used in cardiopulmonary bypass

Reservoir Physical Properties and Micropore Nanocharacteristics of Cores in the Shihezi Formation, Sudong District, Sulige Gas Field, Ordos Basin

Sulige gas field is a very complex large-scale gas field with low porosity, low permeability, low abundance, and strong heterogeneity. In this study, the nanopore structure of the reservoir in the study area was analyzed. The analysis of reservoir physical properties and core microscopic pore characteristics of Shihezi formation in Sudong District, Sulige gas field, Ordos Basin, was put forward. According to core observation, thin section identification, and grain size analysis, the lithology of gas reservoirs in Shan-1 member and He-8 member in the study area is mainly lithic sandstone, lithic quartz sandstone, and quartz sandstone. According to the analysis of physical data in the study area, the reservoirs in Shan-1 member and He-8 member have typical characteristics of low porosity and low permeability. According to that microscopic observation of sandstone thin section and cast thin section combined with the analysis of scan electron microscope, the results show that both Shan-1 member and He-8 member of Sudong area 2 in Sulige gas field are dominated by class I reservoirs and class II reservoirs. Especially, class I reservoirs are widely distributed, with the cumulative area of this type of reservoirs accounting for 70.12% of the total area in Shan section and 64.12% in He-8 section. Class I reservoirs are scattered in the study area, accounting for 0.27% of the total area in the mountain section and 0.36% in the He-8 section. Class IV reservoirs are distributed dispersedly and have a small distribution area. The cumulative area of reservoirs in mountain section accounts for 5.38% of the total area and that in He-8 section accounts for 5.46%. Therefore, Sudong area 2 in Sulige gas field is a typical low porosity and low permeability reservoir. On the basis of geological background, sedimentary microfacies, diagenesis, and pore structure characteristics of the study area, it is considered that the pore structure of sandstone in the study area is mainly controlled by sedimentary characteristics and diagenesis of sandstone.

Blood cell adhesion to arterial filters analysis by scanning electron microscopy and real-time PCR assay: observational clinical study in cardiac surgery patients

INTRODUCTION

Arterial filter is the part of the cardiopulmonary bypass circuit where blood cells are exposed to high mechanical stress and where cellular aggregates may fasten in large quantities. The aim of this study was to analyse blood cell adhesiveness in the arterial filter through scanning electron microscopy and real-time PCR assay.

METHODS

Prospective, clinical and observational study performed on 28 patients undergoing cardiac surgery with cardiopulmonary bypass. Arterial filters were analysed by scanning electron microscopy. Real-time PCR assay was performed in extracted material from the arterial filters for analysis of platelet GPIb and CD45 leucocyte gene expression. Blood coagulation was analysed during cardiopulmonary bypass. Patients were followed until hospital discharge or 28 days after surgery.

RESULTS

All studied arterial filters used in the subject patients showed a degree of adhesion from blood elements at scanning electron microscopy. All studied filters were positive for platelets GPIb gene expression and 15% had CD45 leucocyte gene expression. The GPIb platelet gene expression in blood lowered at the end of cardiopulmonary bypass (p = 0.019). There was negative correlation between blood GPIb platelet gene expression and Clot SR (HEPSCREEN2 ReoRox^®) (rho = 0.635; p = 0.027). The filter fields count was correlated to the D-dimer dosage (rho = 0.828; p < 0.001).

CONCLUSION

There was adhesion of blood elements, especially nucleated platelets, on all arterial filters studied. Although the arterial filter worked as a safety device, that possibly prevented arterial embolisation, it may also have caused greater hyperfibrinolysis during cardiopulmonary bypass.

The scientific evidence of arterial line filtration in cardiopulmonary bypass

BACKGROUND

The indication for arterial line filtration (ALF) is to inhibit embolisation during cardiopulmonary bypass. Filtration methods have developed from depth filters to screen filters and from a stand-alone component to an integral part of the oxygenator. For many years, ALF has been a standard adopted by a majority of cardiac centres worldwide. The following review aims to summarize the available evidence in support for ALF and report on its current practice in Europe.

METHOD

The principles and application of ALF in Europe was investigated using a survey conducted in 2014. The scientific evidence for ALF was examined by performing a systematic literature search in six different databases, using the following search terms: "Cardiopulmonary bypass AND filters AND arterial". The primary endpoint was protection against cerebral injury verified by the degree of cerebral embolisation or cognitive tests. The secondary endpoint was improvement of the clinical outcome verified elsewise. Only randomised clinical trials were considered.

RESULTS

The response rate was 31% (n=112). The great majority (88.5%) of respondents were using ALF, following more than 10 years of experience. Integrated arterial filtration was used by 55%. Of respondents not using ALF, fifty-four percent considered starting using integrated arterial filtration. The systematic literature database search returned 180 unique publications where 82 were specifically addressing ALF in cardiopulmonary bypass. Only four out of the 82 identified publications fulfilled our inclusion criteria. Of these, three were more than 20 years old and based on the use of bubble oxygenation.

CONCLUSION

ALF is a standard implemented in a majority of cardiopulmonary bypass procedures in Europe. The level of scientific evidence available in support of current arterial line filtration methods in cardiopulmonary bypass is, however, poor. Large, well-designed, randomised trials are warranted.