Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
Intensive Care Med. 2010 Apr;36(4):707-11. doi: 10.1007/s00134-010-1775-y. Epub 2010 Feb 18.
To examine the physical properties and chemical composition of particles captured by in-line microfilters in critically ill children, and to investigate the inflammatory and cytotoxic effects of particles on endothelial cells (HUVEC) and macrophages in vitro.
Prospective, observational study of microfilters following their use in the pediatric intensive care unit. In vitro model utilizing cytokine assays to investigate the effects of particles on human endothelial cells and murine macrophages.
Twenty filter membranes from nine patients and five controls were examined by electron microscopy (EM) and energy dispersion spectroscopy (EDX). The average number of particles found on the surface of the used membranes was 550 cm(2). EDX analysis confirmed silicon as a major particle constituent. Half of the filter membranes showed conglomerates containing an unaccountable number of smaller particles. In vitro, glass particles were used to mimic the high silicon content particles. HUVEC and murine macrophages were exposed to different contents of particles, and cytokine levels were assayed to assess their immune response. Levels of interleukin-1beta, interleukin-6, interleukin-8, and tumor necrosis factor alpha were suppressed.
Particle contamination of infusion solutions exists despite a stringent infusion regiment. The number and composition of particles depends on the complexity of the applied admixtures. Beyond possible physical effects, the suppression of macrophage and endothelial cell cytokine secretion in vitro suggests that microparticle infusion in vivo may have immune-modulating effects. Further clinical trials are necessary to determine whether particle retention by in-line filtration has an influence on the outcome of intensive care patients.
检测危重病儿童在线微滤器截留颗粒的物理性质和化学成分，并研究颗粒对体外人内皮细胞（HUVEC）和巨噬细胞的炎症和细胞毒性作用。
在儿科重症监护病房使用微滤器后进行前瞻性观察性研究。采用细胞因子检测法的体外模型研究颗粒对人内皮细胞和鼠巨噬细胞的影响。
用电子显微镜（EM）和能量色散光谱（EDX）检查了 9 名患者和 5 名对照的 20 个滤膜。使用后的膜表面平均有 550 cm(2)的颗粒。EDX 分析证实硅是主要的颗粒成分。一半的滤膜显示出含有大量无法解释的较小颗粒的聚集体。在体外，玻璃颗粒被用来模拟高硅含量的颗粒。将 HUVEC 和鼠巨噬细胞暴露于不同含量的颗粒中，并检测细胞因子水平以评估其免疫反应。白细胞介素-1β、白细胞介素-6、白细胞介素-8 和肿瘤坏死因子-α的水平受到抑制。
尽管有严格的输液方案，但输液溶液中仍存在颗粒污染。颗粒的数量和组成取决于应用添加剂的复杂性。除了可能的物理影响外，体外巨噬细胞和内皮细胞细胞因子分泌的抑制表明体内微颗粒输注可能具有免疫调节作用。需要进一步的临床试验来确定在线过滤截留颗粒是否会影响重症监护患者的结局。
