Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model

Mrinal K. Dewanjee, Shu Ming Wu, Mansoor Kapadvanjwala, Dibyendu De, Sumit Dewanjee, Lipton Gonzalez, Stana Novak, Li Chien Hsu, Richard A. Perryman, Robert C. Duncan, Aldo N Serafini, George N Sfakianakis, Allan F. Horton

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The effect of an arterial filter on visceral emboli was quantified with autologous indium-111 labeled platelets (INPLT) during cardiopulmonary bypass (CPB) in Yorkshire pigs. Biodistribution of INPLT was determined in 12 control pigs (30-35 kg, unoperated control [n = 6] and sham operated control [n = 6]). CPB was carried out with (n = 6) and without (n = 6) an arterial filter in 12 pigs at a flow rate of 2.53.5 L/min. Platelets labeled with in- 111 tropolone (650-780 μCi) were injected intravenously 24 hr before CPB. All pigs were systemically heparinized (activated coagulation time > 400 sec); CPB was instituted with a roller pump, an extraluminal blood flow oxygenator (Bentley Univox, 1.8 m2), and an arterial filter (0.25 m2) and continued for 3 hr. Platelet kinetics, pooling, and counts were monitored by a Geiger probe and a Coulter counter. The thrombi in the oxygenator and arterial filter and emboli in viscera and brain were imaged with a gamma camera and measured with an ion chamber and gamma counter. Percentage of INPLT (mean ± SD) in organs, tissues, and components of the circuit in four groups of pigs was calculated. Flow cytometry with antibodies to CD61 (GPIIIa) and CD62P (GMP-140: control) of porcine platelets was carried out with blood samples taken before, during, and after CPB for estimation of circulating platelet aggregates and platelet microparticles. Pulmonary, renal, cardiac, and cerebral emboli in pigs undergoing CPB with and without a filter were similar (p < 0.1). The amount of filter adherent thrombi was small (0.04 ± 0.01%); oxygenator adherent thrombus in both groups was similar (p < 0.1). Emboli were found in the cerebral medulla, hippocampus, and posterior cerebral cortex in both groups. During CPB, the arterial filter functioned minimally as a trap for platelet thrombi detached from the oxygenator and circulating emboli. Flow cytometry of blood demonstrated the shift of equilibria from single platelets to platelet aggregates and microparticles during CPB and their gradual reversal to single platelets after CPB; the loosely adherent emboli disaggregated and further shifted these equilibria to single platelets and smaller aggregates, probably through the action of endogenous nitric oxide and prostacyclin. The emboli were trapped in organs and tissues and microparticles were sequestered by the reticuloendothelial system.

Original languageEnglish
Pages (from-to)1010-1018
Number of pages9
JournalASAIO Journal
Volume42
Issue number6
StatePublished - Nov 1 1996

Fingerprint

Oxygenators
Platelets
Embolism
Cardiopulmonary Bypass
Blood
Swine
Blood Platelets
Fibers
Indium
Thrombosis
Flow cytometry
Flow Cytometry
Tropolone
Tissue
Integrin beta3
Intracranial Embolism
Mononuclear Phagocyte System
Ionization chambers
Gamma Cameras
P-Selectin

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

Dewanjee, M. K., Wu, S. M., Kapadvanjwala, M., De, D., Dewanjee, S., Gonzalez, L., ... Horton, A. F. (1996). Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model. ASAIO Journal, 42(6), 1010-1018.

Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model. / Dewanjee, Mrinal K.; Wu, Shu Ming; Kapadvanjwala, Mansoor; De, Dibyendu; Dewanjee, Sumit; Gonzalez, Lipton; Novak, Stana; Hsu, Li Chien; Perryman, Richard A.; Duncan, Robert C.; Serafini, Aldo N; Sfakianakis, George N; Horton, Allan F.

In: ASAIO Journal, Vol. 42, No. 6, 01.11.1996, p. 1010-1018.

Research output: Contribution to journalArticle

Dewanjee, MK, Wu, SM, Kapadvanjwala, M, De, D, Dewanjee, S, Gonzalez, L, Novak, S, Hsu, LC, Perryman, RA, Duncan, RC, Serafini, AN, Sfakianakis, GN & Horton, AF 1996, 'Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model', ASAIO Journal, vol. 42, no. 6, pp. 1010-1018.
Dewanjee MK, Wu SM, Kapadvanjwala M, De D, Dewanjee S, Gonzalez L et al. Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model. ASAIO Journal. 1996 Nov 1;42(6):1010-1018.
Dewanjee, Mrinal K. ; Wu, Shu Ming ; Kapadvanjwala, Mansoor ; De, Dibyendu ; Dewanjee, Sumit ; Gonzalez, Lipton ; Novak, Stana ; Hsu, Li Chien ; Perryman, Richard A. ; Duncan, Robert C. ; Serafini, Aldo N ; Sfakianakis, George N ; Horton, Allan F. / Emboli from an extraluminal blood flow hollow fiber oxygenator with and without an arterial filter during cardiopulmonary bypass in a pig model. In: ASAIO Journal. 1996 ; Vol. 42, No. 6. pp. 1010-1018.
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AU - Dewanjee, Mrinal K.

AU - Wu, Shu Ming

AU - Kapadvanjwala, Mansoor

AU - De, Dibyendu

AU - Dewanjee, Sumit

AU - Gonzalez, Lipton

AU - Novak, Stana

AU - Hsu, Li Chien

AU - Perryman, Richard A.

AU - Duncan, Robert C.

AU - Serafini, Aldo N

AU - Sfakianakis, George N

AU - Horton, Allan F.

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N2 - The effect of an arterial filter on visceral emboli was quantified with autologous indium-111 labeled platelets (INPLT) during cardiopulmonary bypass (CPB) in Yorkshire pigs. Biodistribution of INPLT was determined in 12 control pigs (30-35 kg, unoperated control [n = 6] and sham operated control [n = 6]). CPB was carried out with (n = 6) and without (n = 6) an arterial filter in 12 pigs at a flow rate of 2.53.5 L/min. Platelets labeled with in- 111 tropolone (650-780 μCi) were injected intravenously 24 hr before CPB. All pigs were systemically heparinized (activated coagulation time > 400 sec); CPB was instituted with a roller pump, an extraluminal blood flow oxygenator (Bentley Univox, 1.8 m2), and an arterial filter (0.25 m2) and continued for 3 hr. Platelet kinetics, pooling, and counts were monitored by a Geiger probe and a Coulter counter. The thrombi in the oxygenator and arterial filter and emboli in viscera and brain were imaged with a gamma camera and measured with an ion chamber and gamma counter. Percentage of INPLT (mean ± SD) in organs, tissues, and components of the circuit in four groups of pigs was calculated. Flow cytometry with antibodies to CD61 (GPIIIa) and CD62P (GMP-140: control) of porcine platelets was carried out with blood samples taken before, during, and after CPB for estimation of circulating platelet aggregates and platelet microparticles. Pulmonary, renal, cardiac, and cerebral emboli in pigs undergoing CPB with and without a filter were similar (p < 0.1). The amount of filter adherent thrombi was small (0.04 ± 0.01%); oxygenator adherent thrombus in both groups was similar (p < 0.1). Emboli were found in the cerebral medulla, hippocampus, and posterior cerebral cortex in both groups. During CPB, the arterial filter functioned minimally as a trap for platelet thrombi detached from the oxygenator and circulating emboli. Flow cytometry of blood demonstrated the shift of equilibria from single platelets to platelet aggregates and microparticles during CPB and their gradual reversal to single platelets after CPB; the loosely adherent emboli disaggregated and further shifted these equilibria to single platelets and smaller aggregates, probably through the action of endogenous nitric oxide and prostacyclin. The emboli were trapped in organs and tissues and microparticles were sequestered by the reticuloendothelial system.

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