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Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators by High-resolution Microcomputed Tomography: A Feasibility Study.
ASAIO J 2019AJ

Abstract

Coagulative disorders, especially clotting during extracorporeal membrane oxygenation, are frequent complications. Direct visualization and analysis of deposits in membrane oxygenators using computed tomography (CT) may provide an insight into the underlying mechanisms causing thrombotic events. However, the already established multidetector CT (MDCT) method shows major limitations. Here, we demonstrate the feasibility of applying industrial micro-CT (µCT) to circumvent these restrictions. Three clinically used membrane oxygenators were investigated applying both MDCT and µCT. The scans were analyzed in terms of clot volume and local clot distribution. As validation, the clot volume was also determined from the fluid volume, which could be filled into the oxygenators. In addition, cross-sectional CT images were compared with crosscut oxygenators. Based on the µCT findings, a morphological measure (sphericity) for assessing clot structures in membrane oxygenators is introduced. Furthermore, by comparing MDCT and µCT results, an augmentation of the MDCT method is proposed, which allows for improved clot volume determination in a clinical setting.

Authors+Show Affiliations

From the Department of Biofluid Mechanics, Technical University of Applied Sciences Regensburg, Regensburg, Germany. Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany.Department of Radiology, University Hospital Regensburg, Regensburg, Germany.Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany.Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany.Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany.From the Department of Biofluid Mechanics, Technical University of Applied Sciences Regensburg, Regensburg, Germany. Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31609797

Citation

Birkenmaier, Clemens, et al. "Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators By High-resolution Microcomputed Tomography: a Feasibility Study." ASAIO Journal (American Society for Artificial Internal Organs : 1992), 2019.
Birkenmaier C, Dornia C, Lehle K, et al. Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators by High-resolution Microcomputed Tomography: A Feasibility Study. ASAIO J. 2019.
Birkenmaier, C., Dornia, C., Lehle, K., Müller, T., Gruber, M., Philipp, A., & Krenkel, L. (2019). Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators by High-resolution Microcomputed Tomography: A Feasibility Study. ASAIO Journal (American Society for Artificial Internal Organs : 1992), doi:10.1097/MAT.0000000000001089.
Birkenmaier C, et al. Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators By High-resolution Microcomputed Tomography: a Feasibility Study. ASAIO J. 2019 Oct 11; PubMed PMID: 31609797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators by High-resolution Microcomputed Tomography: A Feasibility Study. AU - Birkenmaier,Clemens, AU - Dornia,Christian, AU - Lehle,Karla, AU - Müller,Thomas, AU - Gruber,Michael, AU - Philipp,Alois, AU - Krenkel,Lars, Y1 - 2019/10/11/ PY - 2019/10/15/entrez PY - 2019/10/15/pubmed PY - 2019/10/15/medline JF - ASAIO journal (American Society for Artificial Internal Organs : 1992) JO - ASAIO J. N2 - Coagulative disorders, especially clotting during extracorporeal membrane oxygenation, are frequent complications. Direct visualization and analysis of deposits in membrane oxygenators using computed tomography (CT) may provide an insight into the underlying mechanisms causing thrombotic events. However, the already established multidetector CT (MDCT) method shows major limitations. Here, we demonstrate the feasibility of applying industrial micro-CT (µCT) to circumvent these restrictions. Three clinically used membrane oxygenators were investigated applying both MDCT and µCT. The scans were analyzed in terms of clot volume and local clot distribution. As validation, the clot volume was also determined from the fluid volume, which could be filled into the oxygenators. In addition, cross-sectional CT images were compared with crosscut oxygenators. Based on the µCT findings, a morphological measure (sphericity) for assessing clot structures in membrane oxygenators is introduced. Furthermore, by comparing MDCT and µCT results, an augmentation of the MDCT method is proposed, which allows for improved clot volume determination in a clinical setting. SN - 1538-943X UR - https://www.unboundmedicine.com/medline/citation/31609797/Analysis_of_Thrombotic_Deposits_in_Extracorporeal_Membrane_Oxygenators_by_High-resolution_Microcomputed_Tomography:_A_Feasibility_Study L2 - http://dx.doi.org/10.1097/MAT.0000000000001089 DB - PRIME DP - Unbound Medicine ER -