title: Circulating particles during cardiac surgery.
abstract: Shed blood is known to be a source of lipid micro-emboli in cardiac surgery. The aim of this study was to characterize the occurrence of these particles at different stages of the operation, and to study their occurrence in the circulation at multiple time-points after the retransfusion of shed blood. Forty-four patients undergoing routine surgery with cardiopulmonary bypass were included. Blood was sampled from the surgical field at different sampling locations during the operation. Shed blood was collected in a transfusion bag and retransfused. After which, blood was sampled from the arterial line of the heart-lung machine. A Coulter counter was used for particle determinion. The mean volume of shed blood collected was 340+/-215 ml. Particles in the size range 10-60 microm were found at varying concentrations, with the highest concentrations being found in blood collected after cannulation and from the pleura. After retransfusion of this blood, a biphasic response was seen in the blood drawn from the efferent line of the heart-lung machine. Particles are found in shed blood at all times during cardiac surgery, and when this blood was retransfused an increase was seen in particle concentration in the heart-lung machine.
authors.affiliation: Department of Cardiothoracic Surgery, Center for Heart and Lung Disease, Lund University Hospital, SE-221 85 Lund, Sweden. henrik.jonsson@med.lu.se
authors.forename: Henrik
authors.initials: H
authors.lastname: Jönsson
authors.forename: Atli
authors.initials: A
authors.lastname: Eyjolfsson
authors.forename: Sara
authors.initials: S
authors.lastname: Scicluna
authors.forename: Per
authors.initials: P
authors.lastname: Paulsson
authors.forename: Per
authors.initials: P
authors.lastname: Johnsson
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000295:instrumentation; D004620:Embolism, Fat / Q000097:blood / Q000209:etiology*; D005260:Female; D006355:Heart-Lung Machine; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D013997:Time Factors
chemical_list: D008055:Lipids