Re: AW: AW: [HSF] the little heat exchanger for arch op´s

[prasannasimha]

Roberto,
I am saying the same thing. It should be always less than 10 Deg, the 
lower the better.. Above 10 Deg the bubbles form unacceptably.
A small experiment can be done with the used oxygenator  with remaining 
blood - if rapidly rewarmed and arterial line is clamped and left you 
will see bubbles - just try it. I have used all these methods to 
demonstrate to my Perfusion students the importance of slow rewarming.
Historically the Venotherm was invented to trap bubbles in the venous 
reservoir during rewarming compared to the traditional arterial side  
Brown Harrison Heat exchanger.
Prasanna
Dr. Roberto Battellini wrote:
> Prasanna,
> but our technicians assure 10 grades is risky!, they do it at 8 degrees
> difference. Specially for patients coming from DHCA.
> That´s whyi needed 2 hours!
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha
> Gesendet: Donnerstag, 21. Dezember 2006 14:20
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: AW: [HSF] the little heat exchanger for arch op´s
>
> That is basically why we also do not maintain a gradient of more than 
> 8-10 Degrees C.
> I usually teach this to my perfusion students by heating coca cola.
> Prasanna
> Rwmfglycar at aol.com wrote:
>   
>>  
>> In a message dated 12/21/2006 3:03:14 A.M. Eastern Standard Time,  
>> battr at medizin.uni-leipzig.de writes:
>>
>> Do
>> anyone rewarm with greater difference? And higher temperatures?.  We try
>>     
> to
>   
>> avoid brain ödema.
>>
>>
>>
>> There is another reason for keeping the rewarming gradient under control.
>>     
>
>   
>> Dave Donald (Scottish veterinarian who was part of the team that brought
>>     
> the  
>   
>> Mayo Gibbon machine to clinical use in 1955) showed in 1959 that gas
>>     
> bubbles  
>   
>> coming out of solution during rewarming reached measurable levels when the
>>     
>
>   
>> temperature gradient was too high. I remember a number of 4 deg.  Celsius,
>>     
> and 
>   
>> several cc. accumulating in a fairly short period of time,  but Dave was 
>> assuming that any amount of gas bubbles in the  arterial blood was too
>>     
> much. He did 
>   
>> not have a test that could tell the  damage that might be done in the
>>     
> brain for 
>   
>> instance.
>> Bob
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