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J Thorac Cardiovasc Surg 2002;124:377-386
© 2002 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology (CSP)

Fat contamination of pericardial suction blood and its influence on in vitro capillary-pore flow properties in patients undergoing routine coronary artery bypass grafting

From the Heart Center, Department of Surgery and Perioperative Science, Division of Cardiothoracic Surgery, Umeå University Hospital, Umeå, Sweden.

Supported by the Swedish Society for Medical Research and funds of the Medical Faculty, Umeå University Hospital; the Swedish Medical Research Council (12X-11204); the Swedish Heart and Lung Foundation, and the Heart Foundation of North Sweden.

Received for publication July 11, 2001. Revisions requested Aug 21, 2001; revisions received Nov 27, 2001. Accepted for publication Dec 12, 2001. Address for reprints: K. Gunnar Engström, MD, PhD, Heart Center, Department of Surgery and Perioperative Science, Cardiothoracic Division, Umeå University Hospital, S-901 85 Umeå, Sweden (E-mail: Gunnar.Engstrom.us{at}vll.se).

Objective: Neurologic dysfunction after cardiopulmonary bypass might be due to arterial microembolization. Pericardial suction blood is a possible source of embolic material. Our aim was to determine the capillary-pore flow ability of pericardial suction blood.
Methods: Pericardial suction blood from patients undergoing coronary bypass was collected, and pericardial suction blood and venous blood were sampled at the end of cardiopulmonary bypass and before reinfusion of pericardial suction blood. Pericardial suction blood was (n = 10) or was not (n = 10) prefiltered through a 30-µm cardiotomy screen filter before capillary in vitro analysis. Additionally, in 8 patients the plasma viscosity was measured, and in 5 of these patients, pericardial suction blood capillary deposits were evaluated by using a microscopy-imprint method and fat staining. Capillary flow was tested through 5-µm pore membranes. Tested components were plasma, plasma-eliminated whole-blood resuspension, and leukocyte/plasma-eliminated erythrocyte resuspension. Initial filtration rate and clogging slope expressed the blood-to-capillary interaction.
Results: The plasma-flow profile of pericardial suction blood was highly impaired, with a 47% reduction in initial filtration rate (P < .001) and a 142% steeper clogging slope flow deceleration (P < .01). This difference was not due to a change in pericardial suction blood viscosity, such as by free hemoglobin, which corresponded to 5.7% of the erythrocytes. There were no differences in resuspended whole blood or erythrocytes. The cardiotomy filter had no effect. Microscopy suggested the presence of capillary fat deposits in pericardial suction blood that were not seen with venous plasma (P < .05). The pericardial suction blood volume was 458 ± 42 mL and contained 95.6 ± 9.3 g/L hemoglobin.
Conclusions: The pericardial suction blood plasma capillary flow function was highly impaired by liquid fat. Pericardial suction blood hemoglobin appears worth recovering after fat removal, despite profound hemolysis.

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