Processing scavenged blood with a cell saver reduces cerebral lipid microembolization.
Processing scavenged blood with a cell saver reduces cerebral lipid microembolization.
复制标题
用细胞保护剂处理清除的血液可减少脑脂质微栓塞。
DOI：
10.1016/s0003-4975(00)01588-5
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
HammonJr,JW
中科院分区：
文献类型：
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作者：
Kincaid,EH;Jones,TJ;Stump,DA;Brown,WR;Moody,DM;Deal,DD;HammonJr,JW
在体外循环(CPB)过程中，脑内可检测到微栓塞症，形成小的毛细血管和小动脉扩张(SCAD)，并伴有缺血性损伤和神经元功能障碍。SCAD密度随着心脏切开吸引术的使用而增加。目的探讨体外循环中不同处理方法对脑组织脂质微栓子负荷的影响。方法低温体外循环(CPB)70min后，对两组犬(28~35 kg)的脑组织进行SCADS检测。动脉滤器(AF)组(n=12)，在心脏切开吸引池中收集流出的血液，通过动脉回路回输。三种不同的动脉滤器(Pall LeukoGuard、Pall StatPrime、Bentley Duraflo)单独和不同的组合使用。在细胞保留器(CS)组(n=12)中，将脱落血收集在间歇预处理的细胞保留器(Medtronic Autolog模型)或连续作用细胞保存器(Fresenius连续自动输血系统)中，并通过CPB回路回输有无白细胞过滤。结果CS组的平均SCAD密度(SCAD/cm2)低于AF组(11±3vs24±5，P=0.02)。白细胞滤过器和不同动脉滤器的SCAD密度无显著差异。连续作用节流器的平均SCAD密度为8±2，间歇式节流器的平均SCAD密度为13±5。结论CPB期间使用细胞节流器清除流出的血液可减少脑组织脂质微栓塞率。
BackgroundMicroembolization 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.MethodsAfter 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.ResultsMean SCAD density (SCAD/cm2) 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.ConclusionsUse of a cell saver to scavenge shed blood during CPB decreases cerebral lipid microembolization.