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Cardiorespiratory effects of venous lipid micro embolization in an experimental model of mediastinal shed blood reinfusion.

Eyjolfsson, Atli LU ; Plaza, Ignacio LU ; Brondén, Björn LU ; Johnsson, Per; Dencker, Magnus LU and Bjursten, Henrik LU (2009) In Journal of Cardiothoracic Surgery 4(48).
Abstract
BACKGROUND: Retransfusion of the patient's own blood during surgery is used to reduce the need for allogenic blood transfusion. It has however been found that this blood contains lipid particles, which form emboli in different organs if the blood is retransfused on the arterial side. In this study, we tested whether retransfusion of blood containing lipid micro-particles on the venous side in a porcine model will give hemodynamic effects. METHODS: Seven adult pigs were used. A shed blood surrogate containing 400 ml diluted blood and 5 ml radioactive triolein was produced to generate a lipid embolic load. The shed blood surrogate was rapidly (<2 minutes) retransfused from a transfusion bag to the right atrium under general anesthesia.... (More)
BACKGROUND: Retransfusion of the patient's own blood during surgery is used to reduce the need for allogenic blood transfusion. It has however been found that this blood contains lipid particles, which form emboli in different organs if the blood is retransfused on the arterial side. In this study, we tested whether retransfusion of blood containing lipid micro-particles on the venous side in a porcine model will give hemodynamic effects. METHODS: Seven adult pigs were used. A shed blood surrogate containing 400 ml diluted blood and 5 ml radioactive triolein was produced to generate a lipid embolic load. The shed blood surrogate was rapidly (<2 minutes) retransfused from a transfusion bag to the right atrium under general anesthesia. The animals' arterial, pulmonary, right and left atrial pressure were monitored, together with cardiac output and deadspace. At the end of the experiment, an increase in cardiac output and pulmonary pressure was pharmacologically induced to try to flush out lipid particles from the lungs. RESULTS: A more than 30-fold increase in pulmonary vascular resistance was observed, with subsequent increase in pulmonary artery pressure, and decrease in cardiac output and arterial pressure. This response was transient, but was followed by a smaller, persistent increase in pulmonary vascular resistance. Only a small portion of the infused triolein passed the lungs, and only a small fraction could be recirculated by increasing cardiac output and pulmonary pressure. CONCLUSION: Infusion of blood containing lipid micro-emboli on the venous side leads to acute, severe hemodynamic responses that can be life threatening. Lipid particles will be trapped in the lungs, leading to persistent effects on the pulmonary vascular resistance. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Cardiothoracic Surgery
volume
4
issue
48
publisher
BioMed Central
external identifiers
  • WOS:000270927800001
  • PMID:19754936
  • Scopus:70449427631
ISSN
1749-8090
DOI
10.1186/1749-8090-4-48
language
English
LU publication?
yes
id
0716c321-a759-486c-8ab9-61b82c14451f (old id 1483482)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19754936?dopt=Abstract
date added to LUP
2009-10-07 10:35:09
date last changed
2016-10-21 09:24:43
@misc{0716c321-a759-486c-8ab9-61b82c14451f,
  abstract     = {BACKGROUND: Retransfusion of the patient's own blood during surgery is used to reduce the need for allogenic blood transfusion. It has however been found that this blood contains lipid particles, which form emboli in different organs if the blood is retransfused on the arterial side. In this study, we tested whether retransfusion of blood containing lipid micro-particles on the venous side in a porcine model will give hemodynamic effects. METHODS: Seven adult pigs were used. A shed blood surrogate containing 400 ml diluted blood and 5 ml radioactive triolein was produced to generate a lipid embolic load. The shed blood surrogate was rapidly (&lt;2 minutes) retransfused from a transfusion bag to the right atrium under general anesthesia. The animals' arterial, pulmonary, right and left atrial pressure were monitored, together with cardiac output and deadspace. At the end of the experiment, an increase in cardiac output and pulmonary pressure was pharmacologically induced to try to flush out lipid particles from the lungs. RESULTS: A more than 30-fold increase in pulmonary vascular resistance was observed, with subsequent increase in pulmonary artery pressure, and decrease in cardiac output and arterial pressure. This response was transient, but was followed by a smaller, persistent increase in pulmonary vascular resistance. Only a small portion of the infused triolein passed the lungs, and only a small fraction could be recirculated by increasing cardiac output and pulmonary pressure. CONCLUSION: Infusion of blood containing lipid micro-emboli on the venous side leads to acute, severe hemodynamic responses that can be life threatening. Lipid particles will be trapped in the lungs, leading to persistent effects on the pulmonary vascular resistance.},
  author       = {Eyjolfsson, Atli and Plaza, Ignacio and Brondén, Björn and Johnsson, Per and Dencker, Magnus and Bjursten, Henrik},
  issn         = {1749-8090},
  language     = {eng},
  number       = {48},
  publisher    = {ARRAY(0xb6d8c88)},
  series       = {Journal of Cardiothoracic Surgery},
  title        = {Cardiorespiratory effects of venous lipid micro embolization in an experimental model of mediastinal shed blood reinfusion.},
  url          = {http://dx.doi.org/10.1186/1749-8090-4-48},
  volume       = {4},
  year         = {2009},
}