Processing scavenged blood with a cell saver reduces cerebral lipid microembolization

被引:94
作者
Kincaid, EH
Jones, TJ
Stump, DA
Brown, WR
Moody, DM
Deal, DD
Hammon, JW
机构
[1] Wake Forest Univ, Sch Med, Dept Cardiothorac Surg, Winston Salem, NC 27157 USA
[2] Wake Forest Univ, Sch Med, Dept Anesthesiol, Winston Salem, NC 27157 USA
[3] Wake Forest Univ, Sch Med, Dept Radiol, Winston Salem, NC 27157 USA
关键词
D O I
10.1016/S0003-4975(00)01588-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Microembolization during cardiopulmonary bypass (CPB) can be detected in the brain as lipid deposits that create small capillary and arteriolar dilations (SCADs) with ischemic injury and neuronal dysfunction. SCAD density is increased with the use of cardiotomy suction to scavenge shed blood. Our purpose was to determine whether various methods of processing shed blood during CPB decrease cerebral lipid microembolic burden. Methods. After hypothermic CPB (70 minutes), brain tissue from two groups of mongrel dogs (28 to 35 kg) was examined for the presence of SCADs. In the arterial filter (AF) group (n = 12), shed blood was collected in a cardiotomy suction reservoir and reinfused through the arterial circuit. Three different arterial line filters (Pall LeukoGuard, Pall StatPrime, Bentley Duraflo) were used alone and in various combinations. In the cell saver (CS) group (n = 12), shed blood was collected in a cell saver with intermittent preocessing (Medtronic autoLog model) or a continuous-action cell saver (Fresenius Continuous Auto Transfusion System) and reinfused with and without leukocyte filtration through the CPB circuit. Results. Mean SCAD density (SCAD/cm(2)) in the CS group was less than the AF group (11 +/- 3 vs 24 +/- 5, p = 0.02). There were no significant differences in SCAD density with leukocyte filtration or with the various arterial line filters. Mean SCAD density for the continuous-action cell saver was 8 +/- 2 versus 13 +/- 5 for the intermittent-action device. Conclusions. Use of a cell saver to scavenge shed blood during CPB decreases cerebral lipid microembolization. (C) 2000 by The Society of Thoracic Surgeons.
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页码:1296 / 1300
页数:5
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