20. PROCESSING SCAVENGED BLOOD DURING CARDIOPULMONARY BYPASS REDUCES CEREBRAL LIPID MICROEMBOLIZATION
Edward H. Kincaid, Timothy J. Jones, David A. Stump, William R. Brown, Dixon M. Moody, Dwight D. Deal, John W. Hammon*
Wake Forest University School of Medicine
Winston-Salem, North Carolina, USA
BACKGROUND
Microembolization during cardiopulmonary bypass (CPB) is detected in the brain as lipid deposits that create small capillary and arterial dilations (SCADs) with a surrounding inflammatory reaction. SCAD density is increased with the use of cardiotomy suction to scavenge shed blood. The processing of shed blood with cell savers and other filtration devices has potential usefulness in removing lipid emboli. Our purpose was to determine whether various methods of processing shed blood during CPB decreases cerebral lipid microembolic burden.
MATERIAL AND METHODS
After hypothermic CPB (70 minutes), brain tissue from mongrel dogs (25-35 kg) was harvested and examined for the presence of SCADs. The dogs were divided into two groups. In group I (n=12), shed blood was collected in a cardiotomy suction reservoir and reinfused into the arterial circuit. Three arterial line filters (Pall LeukaGuard, PL; Pall StatPrime, PS; Bentley Duraflo, B) were used alone and in various combinations. In group II (n=8), shed blood was collected in a cell-saver (CS) and reinfused with and without leukocyte filtration (LF) into the CPB circuit.
RESULTS
Mean SCAD density in group II was less than group I (13
± 5 vs 24 ± 5, P=0.07). There were no intergroup differences.|
Group |
Filter |
n |
SCADs(/cm2)* |
|
I |
PL B PL+PS PL+B |
4 4 2 2 |
29 ± 419 ± 631 ± 2717 ± 8 |
|
II |
CS CS+LF |
4 4 |
17 ± 89 ± 6 |
|
*mean ± SEM |
|||
CONCLUSIONS
Use of a cell-saver to scavenge shed blood during CPB decreases cerebral lipid microembolization.
