经颅多普勒与库尔特计数器在检测心脏手术中纵隔引流血回输引起的脂质微栓塞方面的比较。
Comparison between transcranial Doppler and Coulter counter for detection of lipid micro embolization from mediastinal shed blood reinfusion during cardiac surgery.
作者信息
Eyjolfsson A, Al-Rashidi F, Dencker M, Scicluna S, Brondén B, Koul B, Bjursten H
机构信息
Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden.
出版信息
Perfusion. 2011 Nov;26(6):519-23. doi: 10.1177/0267659111419033. Epub 2011 Aug 15.
INTRODUCTION
Lipid micro embolization (LME) from re-transfused shed blood has been postulated to be a potential reason for short- and long-term cognitive dysfunction after cardiac surgery. The purpose of this investigation was to evaluate if transcranial Doppler (TCD) has the capacity to detect LME.
METHODS
Thirteen patients undergoing cardiopulmonary bypass surgery were investigated. Each patient's cerebral circulation was monitored with transcranial Doppler during the first two minutes after re-transfusion of shed blood and blood was simultaneously sampled and characterised by a Coulter counter.
RESULTS
Strong correlation was found between embolic loads, as measured by transcranial Doppler and Coulter counter (r=0.79, P<0.005).
CONCLUSIONS
This pilot study shows that non-invasive monitoring by transcranial Doppler could be a potential tool to monitor LME during cardiopulmonary bypass surgery.
引言
再输注失血导致的脂质微栓塞（LME）被认为是心脏手术后短期和长期认知功能障碍的一个潜在原因。本研究的目的是评估经颅多普勒（TCD）是否有能力检测LME。
方法
对13例行体外循环手术的患者进行了研究。在回输失血后的前两分钟内，用经颅多普勒监测每位患者的脑循环，并同时采集血液样本，用库尔特计数器进行分析。
结果
经颅多普勒和库尔特计数器测得的栓塞负荷之间存在强相关性（r = 0.79，P < 0.005）。
结论
这项初步研究表明，经颅多普勒的无创监测可能是体外循环手术期间监测LME的一种潜在工具。
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