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Ann Thorac Surg 1992;54:1196-1202
© 1992 The Society of Thoracic Surgeons

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Articles

Quantitation of particulate microemboli during cardiopulmonary bypass: Experimental and clinical studies

Department of Pediatric Cardiothoracic Surgery, Xin Hua Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China

Accepted for publication July 20, 1992.

^_* Address reprint requests to Dr Liu, Department of Pediatric Cardiothoracic Surgery, Xin Hua Hospital, 1665 Kong Jiang Rd, Shanghai, People's Republic of China 200092.

An electronic particle-size analyzer (Coulter Counter ZM) was used to quantitate particulate microemboli 15 to 80 µm 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 µm 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.

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