Characterization of Lipid Particles in Shed Mediastinal Blood

Eyjolfsson, Atli; Scicluna, Sara; Johnsson, Per; Petersson, Filip; Jönsson, Henrik

doi:10.1016/j.athoracsur.2007.12.067

Cited by 12 publications

(16 citation statements)

References 16 publications

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“…Current methods utilized for blood salvage use either filters or centrifugal techniques to separate blood, resulting in moderate levels of RBC separation and return. Typical filters have a pore size of 25 or 40 lm and their removal efficacy is limited to 30-40% [3,5,6], which is consistent with the finding that most lipid particles are less than 20 lm [7]. Filters also become saturated over time, require replacement, and have the potential to disperse larger particles into smaller ones.…”

Section: Introductionsupporting

confidence: 69%

“…In this way, when the shed blood is processed through a tuned acoustic field, the device could acoustically filter lipids from the major components of blood. Prior work in this space has shown that acoustophoresis may be an effective cell concentrator and lipid removal technology [7]. The feasibility of this approach has been demonstrated on the microscale in micro-electromechanical system (MEMS) work by using acoustophoresis to sort lipid and blood cells into different outlets [2], but hundreds of the MEMS chips operating in parallel would be required to meet the volume and flow rates required for real world application.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Macroscale Acoustic Device for Blood Filtration

Dutra

Mora

Gerhardson

et al. 2018

Journal of Medical Devices

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Retransfusion of a patient's own shed blood during cardiac surgery is attractive since it reduces the need for allogeneic transfusion, minimizes cost, and decreases transfusion related morbidity. Evidence suggests that lipid micro-emboli associated with the retransfusion of the shed blood are the predominant causes of the neurocognitive disorders. We have developed a novel acoustophoretic filtration system that can remove lipids from blood at clinically relevant flow rates. Unlike other acoustophoretic separation systems, this ultrasound technology works at the macroscale, and is therefore able to process larger flow rates than typical micro-electromechanical system (MEMS) scale acoustophoretic separation devices. In this work, we have first demonstrated the systematic design of the acoustic device and its optimization, followed by examining the feasibility of the device to filter lipids from the system. Then, we demonstrate the effects of the acoustic waves on the shed blood; examining hemolysis using both haptoglobin formation and lactate dehydrogenase release, as well as the potential of platelet aggregation or inflammatory cascade activation. Finally, in a porcine surgical model, we determined the potential viability of acoustic trapping as a blood filtration technology, as the animal responded to redelivered blood by increasing both systemic and mean arterial blood pressure.

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Section: Introductionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

A Novel Macroscale Acoustic Device for Blood Filtration

Dutra

Mora

Gerhardson

et al. 2018

Journal of Medical Devices

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“…It is, therefore, not possible to be certain of the exact nature of these particles. A previous investigation by our group has shown convincingly that particles counted by the Coulter counter correlate to particles in the form of LME visualised by scanning electron microscopy 4 . We restricted our analyses of LME to particles ranging from 10 and 60 µm in size.…”

Section: Discussionmentioning

confidence: 86%

“…Our group and others have described the presence of lipid material in shed blood 3,4,12,13 . Moreover, we have previously shown this lipid material can form embolic material ranging from 2 to 60 microns and that these particles enter the circulation when shed blood is re-transfused 4,5 .…”

Section: Discussionmentioning

confidence: 95%

Comparison between transcranial Doppler and Coulter counter for detection of lipid micro embolization from mediastinal shed blood reinfusion during cardiac surgery

et al. 2011

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“…7,8 As a consequence, re-transfusion of pericardial suction blood aggravates CPB-associated SIRS 9,10 and increases the lipid embolic load. 11 Therefore, avoidance of direct re-transfusion of unprocessed shed mediastinal blood (SMB) is recommended.…”

mentioning

confidence: 99%