Clinical evaluation of a new fat removal filter during cardiac surgery.
OBJECTIVE
Fat microemboli are generated during cardiac surgery that are associated with post-operative organ injury. Recently, a fat removal filter has been developed, based on a polyester leukocyte depletion filter. However, the efficacy of such a filter in a clinical setting is unknown. In this study we tested the efficacy of this filter.


METHODS
Coronary artery bypass patients were randomly divided into two groups. Group I: filtration of cardiotomy suction blood during cardiopulmonary bypass with a fat removal filter (n=14). Group II: control patients without filtration (n=14). Filter efficacy was evaluated in group I using biochemical assays and thin layer chromatography of blood samples taken simultaneously before and after the filter. In addition, clinical and biochemical markers for organ injury were determined in both groups.


RESULTS
The fat filter removed triglycerides (0.9+/-0.08 vs. 0.63+/-0.08 mmol l(-1), P=0.004, paired t-test), leukocytes (4.3+/-0.8 x 10(9) vs. 2.3+/-0.6 x 10(9)l(-1), P=0.03), and platelets (116+/-26 x 10(9) vs. 75+/-21 x 10(9)l(-1), P=0.003) from the blood samples taken before and after the filter. Chromatography showed a significant reduction in free fatty acids, phospholipids and triglycerides. Clinically, leukocyte counts were similar, but platelet counts were higher (181+/-14 x 10(9) vs. 117+/-8.6 x 10(9)l(-1) control, P<0.001) in group I on the first postoperative day.


CONCLUSIONS
The fat filter removed 40% fat, leukocytes and platelets from cardiotomy suction blood during cardiac surgery. A larger scale study is necessary to determine clinical effects on organ damage.
de Vries
Adrianus J
AJ
Department of Anesthesiology, University Hospital Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.j.de.vries@anest.azg.nl
Gu
Y John
YJ
Douglas
Yvonne L
YL
Post
Wendy J
WJ
Lip
Harm
H
van Oeveren
Willem
W
D000368:Aged; D001781:Blood Component Removal / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004620:Embolism, Fat / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D010976:Platelet Count; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D010100:Oxygen