Acoustical bubble trapper applied to hemodialysis.

Gaseous microemboli can arise in extracorporeal lines and devices such as dialysis machines. They are associated with severe pulmonary side effects in patients undergoing chronic hemodialysis sessions. The goal of this study was to develop a gaseous emboli trapper using ultrasound waves to remove any air bubble from the tubing system before they reach the patient. A homemade bubble trapper, developed in the laboratory, consists of a Perspex block containing a main channel connected to the tubing of a hemodialysis machine and a second subchannel positioned perpendicularly to the main one, used to trap the air microemboli. The microemboli flowing in the main channel were insonified through an acoustic window with an ultrasound wave, at a frequency of 500 kHz and with a maximal acoustic pressure of 500 kPa, generated by a single-element transducer positioned 3 cm away from the main flow. The radiation force induced by the ultrasound beam acts directly on the flowing air emboli, by pushing them into the subchannel. Two Doppler probes operating both at 2 MHz, connected to a DWL Doppler machine were placed before and after the bubble trapper to count sequentially the number of embolic events. The flow of the machine was varied between 200 mL/min and 500 mL/min. Depending on the flow velocity, the number of microembolic signals (MES) detected by the Doppler probes before and after the trapping system was identical and ranged from 5 to 150 MES/min in absence of the ultrasound irradiation. When the air bubble trapper was activated, a reduction of the number of MES, up to 70%, was achieved. Doppler recordings suggest that the circulating bubbles were either fragmented into smaller bubble fragments or directly got pushed into the second subchannel where they were collected. This simple approach using an ultrasound-based trapping system was shown to operate adequately with the current settings and can be used to filter air microemboli.