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The Annals of Thoracic Surgery, Vol 54, 1196-1202, Copyright © 1992 by The Society of Thoracic Surgeons
JF Liu, ZK Su and WX Ding
An electronic particle-size analyzer (Coulter Counter ZM) was used to
quantitate particulate microemboli 15 to 80 microns in size during
cardiopulmonary bypass. Through both laboratory studies and clinical
research, we confirmed three main causes of microemboli: (1) infusion of
banked blood stored for more than 3 days; (2) use of cardiotomy reservoirs;
and (3) use of bubble oxygenators. The regression equation between number
of particles and blood storage time was Y = 3.7262X + 10.244 (r = 0.886; p
< 0.01). The number of microemboli from cardiotomy reservoirs was 2.8 to
5.1 times that from other sources (p < 0.01). The number of solid
particles from bubble oxygenators was 1.8 to 3.2 times that from membrane
oxygenators (p < 0.01). Electron microscopy showed that a large number
of solid particles more than 20 microns in size were formed during
heart-lung bypass. They obstructed the microcirculation and damaged
pulmonary capillary endothelial and alveolar epithelial cells. The degree
of histological damage was related to the number and size of microemboli
and the duration of pulmonary microcirculatory obstruction.
ARTICLES
Quantitation of particulate microemboli during cardiopulmonary bypass: experimental and clinical studies
Department of Pediatric Cardiothoracic Surgery, Xin Hua Hospital, Shanghai Second Medical University, People's Republic of China.
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