The kinetics of lipid micro-emboli during cardiac surgery studied in a porcine model.
OBJECTIVE
To study the kinetics of lipid micro-emboli during cardiac surgery.


METHODS
Eleven pigs were studied. Seven of these were put on extracorporeal circulation. A shed blood phantom consisted of blood, saline and radioactive triolein was added to the circuit. Both venous and arterial blood samples were taken at short intervals. Four animals were used to study renal kinetics without extracorporeal circulation. The same kind of shed blood phantom was infused into the ascending aorta. Samples were taken from the renal artery and vein. All samples were analyzed for radioactivity by scintillation counting.


RESULTS
A median 130-fold increase in radioactivity was seen in the blood and was quickly eliminated. Systemic first-pass wedging was found to be 62%. The first-pass elimination in the kidney was 77%. No radioactivity was found in urine.


CONCLUSIONS
This study shows that the turnover of lipid micro-emboli is fast, and that the majority of the emboli are trapped on their first passage through the capillary system. No evidence was found of a renal excretion of these lipid emboli.
Brondén
Björn
B
Department of Cardiothoracic Anaesthesiology, Center for Heart and Lung Disease, Lund University Hospital, Lund, Sweden. Bjorn.Bronden@skane.se
Dencker
Magnus
M
Blomquist
Sten
S
Plaza
Ignacio
I
Allers
Mats
M
Jönsson
Henrik
H
D000818:Animals; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004195:Disease Models, Animal; D004620:Embolism, Fat / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply; D019047:Phantoms, Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D012039:Regional Blood Flow; D012079:Renal Circulation; D012588:Scintillation Counting / Q000295:instrumentation; D013552:Swine; D014304:Triolein / Q000008:administration & dosage / Q000493:pharmacokinetics*; D014316:Tritium
D019275:Radiopharmaceuticals; D014316:Tritium; D014304:Triolein