Bull Brian S, Hay Karen
School of Medicine, Department of Pathology and Human Anatomy, Loma Linda University, Loma Linda, CA 92354, United States.
Blood Cells Mol Dis. 2005 Mar-Apr;34(2):141-3. doi: 10.1016/j.bcmd.2004.11.002.
Blood accumulating in the pericardial sac is routinely reinfused during cardiopulmonary bypass (CPB) surgery. Such reinfusion has been associated with an increased incidence of serious complications such as coagulopathy, systemic inflammation, and neurologic sequelae. We hypothesize that some of these complications occur because the reinfused blood has been exposed to and activated by laparotomy sponges used to elevate the heart during vein graft emplacement. Such laparotomy sponges expose accumulating pericardial blood to a large, raw, cotton surface with an area approximately five times that of the CPB circuit (excluding the biocompatible oxygenator membrane). Because the reinfused blood has been exposed to this surface, the sponge becomes, in essence, a significant-though inapparent-part of the CPB circuit. Steps should be taken to either eliminate the sponge or to reduce the area of this foreign surface and make it more biocompatible.
在体外循环（CPB）手术期间，通常会将积聚在心包囊内的血液回输。这种回输与严重并发症的发生率增加有关，如凝血病、全身炎症和神经后遗症。我们推测，这些并发症的发生部分原因是回输的血液在静脉移植血管置入过程中被用于抬高心脏的剖腹术海绵接触并激活。这种剖腹术海绵使积聚的心包血液暴露于一个大的、粗糙的棉质表面，其面积约为CPB回路（不包括生物相容性氧合器膜）的五倍。由于回输的血液已接触该表面，海绵实际上成为了CPB回路中一个重要但不明显的部分。应采取措施消除海绵，或减少该异物表面的面积并使其更具生物相容性。
