What is it about?
Large bubbles do not enter the patient, they are hold back in the venous bubble catcher, but tiny bubbles < 0.2 mm are given back to the patient together with the cleaned blood.
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Why is it important?
Micro bubbles present no risk concerning air embolism, as the amount of air in the micro bubbles is too small. But these invisible micro bubbles (e.g. 30.000 during standard dialysis) have a total surface area which is much larger than the visible blood air contact area in the venous bubble catcher, and this "incorporated artificial contact area" might cause problems in small capillaries (e.g. in lung and brain, which might add to the increasing pulmonary problem and cognitive function decline observed in dialysis patients).
Perspectives
A careful priming procedure aiming at reducing sources for micro bubbles and a clever choice of treatment parameters (especially of the negative arterial pressure) might keep the number of injected micro bubbles on an acceptable level during standard treatment.
Dr. Ralf G. Wojke
Fresenius Medical Care
Read the Original
This page is a summary of: Observation of microbubbles during standard dialysis treatments, Clinical Kidney Journal, July 2015, Oxford University Press (OUP),
DOI: 10.1093/ckj/sfv051.
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