title: Comparison between transcranial Doppler and Coulter counter for detection of lipid micro embolization from mediastinal shed blood reinfusion during cardiac surgery.
abstract: BACKGROUND
  Lipid micro embolization (LME) from re-transfused shed blood has been postulated to be a potential reason for short- and long-term cognitive dysfunction after cardiac surgery. The purpose of this investigation was to evaluate if transcranial Doppler (TCD) has the capacity to detect LME.
  
  
  METHODS
  Thirteen patients undergoing cardiopulmonary bypass surgery were investigated. Each patient's cerebral circulation was monitored with transcranial Doppler during the first two minutes after re-transfusion of shed blood and blood was simultaneously sampled and characterised by a Coulter counter.
  
  
  RESULTS
  Strong correlation was found between embolic loads, as measured by transcranial Doppler and Coulter counter (r=0.79, P<0.005).
  
  
  CONCLUSIONS
  This pilot study shows that non-invasive monitoring by transcranial Doppler could be a potential tool to monitor LME during cardiopulmonary bypass surgery.
authors.affiliation: Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Eyjolfsson
authors.forename: F
authors.initials: F
authors.lastname: Al-Rashidi
authors.forename: M
authors.initials: M
authors.lastname: Dencker
authors.forename: S
authors.initials: S
authors.lastname: Scicluna
authors.forename: B
authors.initials: B
authors.lastname: Brondén
authors.forename: B
authors.initials: B
authors.lastname: Koul
authors.forename: H
authors.initials: H
authors.lastname: Bjursten
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004620:Embolism, Fat / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000098:blood supply / Q000601:surgery; D008875:Middle Aged; D010316:Particle Size; D010865:Pilot Projects; D065227:Transfusion Reaction; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*