Fat Elimination from Autologous Blood

Booke, Michael; Aken, Hugo Van; Storm, Martin; Fritzsche, Florian; Wirtz, Stefan; Hinder, Frank

doi:10.1213/00000539-200102000-00011

Cited by 27 publications

(20 citation statements)

References 16 publications

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“…Current autotransfusion devices, such as the Haemonetics Cell Saver (the device used at our institution), may reduce but not completely eliminate fat particles in salvaged blood (21). These fat cells may agglutinate in circulation and lodge in the pulmonary vasculature, potentially leading to fat embolism syndrome.…”

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary fat embolism following spinal fusion surgery

Stroud

McCarthy

Parham

et al. 2006

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 99%

Fatal pulmonary fat embolism following spinal fusion surgery

Stroud

McCarthy

Parham

et al. 2006

Pediatric Critical Care Medicine

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“…Also, Ramirez et al, using an automated fat particle analysis, demonstrated a moderate efficacy of this filter in orthopedic patients (9). Booke et al, in contrast, demonstrated with 60% fat removal a higher efficacy of this filter in a laboratory study (7). However, they used reconstituted blood with soy oil, in contrast to the more clinical approach that we chose, which may explain this discrepancy.…”

Section: Discussionmentioning

confidence: 96%

“…Filters may therefore be used to remove either leukocytes or fat particles during a cardiac surgery. However, by its structure and nature a leukocyte removal filter also removes fat particles (7), and a fat removal filter also removes leukocytes, be it not at the same efficiency (8). A novel approach with a filter that combines both properties might be clinically useful.…”

mentioning

confidence: 99%

Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

Vries¹,

Vermeijden²,

et al. 2006

Artificial Organs

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Activated leukocytes and fat particles are associated with organ injury after a cardiac surgery. Filters are currently used to remove either leukocytes or fat particles. A novel approach with a filter that combines leukocyte and fat removal might be clinically useful. As it is not known which type of filter has a good and safe performance in both leukocyte and fat removal, we measured in this study the leukocyte and fat removal properties and the biocompatibility of three different filters. We used six Pall RS1 (Pall, Portsmouth, England) leukocyte removal filters, six Pall LipiGuard fat removal filters, and six Fresenius Biofil 02 (Fresenius, Emmer-Compascuum, The Netherlands) leukocyte removal filters and measured the passage times of 500 and 1000 mL of residual heart-lung machine blood. We determined the circulating leukocyte and platelet counts, and total hemoglobin, triglyceride, and free fatty acid concentration after the filters. In addition, we measured free hemoglobin, plasma elastase (Merck, Darmstadt, Germany), and complement C5-9 (Quidel, San Diego, CA, U.S.A.) to assess the biocompatibility of the filters. The circulating fat particles were calculated with an automated hematology analyzer. The passage time for the blood was shortest for the Biofil filter (P = 0.02, analysis of variance). The total leukocyte counts (P = 0.04) and fat particles (P = 0.02) were higher after the LipiGuard filter. This filter also had a higher increase in free hemoglobin concentration (P = 0.03). We conclude that the leukocyte removal filters were superior to the fat removal filter both in leukocyte and fat removal.

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“…Other approaches have been proposed and developed to increase fat removal. The stickiness of human fat at room temperature (in contrast to oil used in some studies) can facilitate separation in a special bag system or in blood filters . But these methods, which are additional to the autotransfusion systems, are time‐consuming and increase RBC loss and haemolysis.…”

Section: Discussionmentioning

confidence: 99%

“…Obviously, there exist other factors that in part prevent fat despite its very light density from leaving the separation chamber, both in continuous and discontinuous autotransfusion devices . In experiments with soya bean oil or with fat from human fat tissue, fat removal rates of just 70–80% have been observed for bowl‐based separation chambers, significantly lower than with the continuous C.A.T.S system . Further studies showed that fat removal can be increased by filtration, or by modifications in the process parameters and the program .…”

Section: Introductionmentioning

confidence: 99%

A new approach for fat removal in a discontinuous autotransfusion device–concept and evaluation

et al. 2017

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Background Fat present during blood salvage in orthopaedic or cardiac surgery can pose a risk of fat embolism and should be eliminated before transfusion. Based on observations of central fat accumulation at the bottom of Latham bowls, a fat reduction program was developed using two volume displacements, where blood temporarily is removed and respun in the bowl to force the fat through the RBC sediment. Materials and MethodsPooled ABO-matched RBC and FFP were adjusted to a haematocrit of 10%, and human fat tissue added to a concentration of 1Á25 vol%. In six experiments, blood was processed with the new-generation cell salvage device CS Elite in a newly developed fat reduction program in bowls of three sizes. Volumetric quantification of fat was performed after centrifugation of blood samples in Pasteur pipettes. From volumes, haematocrits and the concentrations of fat, RBC recovery and fat elimination rates were calculated.Results Fat removal rates of 93Á2 -2Á8, 97Á0 -2Á1 and 99Á6 -0Á3% were observed with a 70-ml, 125-ml and 225-ml bowl, respectively, and even higher rates when removal rates were calculated one cycle. At the same time, high RBC recovery and plasma elimination rates were maintained, not significantly different to the default program mode.Conclusion Modifications in process parameters and sequence led to a fat reduction program that significantly improves fat removal with the Cell Saver Elite from 77Á4 -5Á1% in the default mode to an average of 98Á6 -1Á1%, yielding results equivalent to the continuous cell salvage system (C.A.T.S).

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Fat Elimination from Autologous Blood

Cited by 27 publications

References 16 publications

Fatal pulmonary fat embolism following spinal fusion surgery

Fatal pulmonary fat embolism following spinal fusion surgery

Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

A new approach for fat removal in a discontinuous autotransfusion device–concept and evaluation

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