Hazards with electrocautery-induced decomposition of fatty acids - in view of lipid embolization
2010 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, Vol. 44, no 5, 307-312 p.Article in journal (Refereed) Published
Objectives. Electrocautery is an appreciated surgical tool, which however, generates immense heat and fat-tissue melting. In cardiac surgery, liquefied fat collects on the surface of blood in the pericardial cavity and becomes aspirated by the heart-lung machine for aortic recycling. Deposits seen in the brain microcirculation after surgery are caused by lipid embolism. This study investigates lipid chemistry, whether heat from electrocautery generates fatty-acid fragmentation and decomposition. Design. Pericardial fat tissue was sampled from cardiac-surgery patients and from piglets. The human tissue was exposed to electrocautery, or to fixed temperatures in an in vitro model. Fatty-acid decomposition was explored by solid-phase microextraction gas chromatography and the distribution of fatty acids was measured. Results. Fatty-acid decomposition demonstrated a temperature-effect relationship (p=0.007). At 350 degrees C the proportion of polyunsaturated fatty acids became heavily reduced or were abolished (p=0.016). Electrocautery resulted in similar changes. Conclusions. Electrocautery induces a profound fatty-acid fragmentation to form short-chained compounds. The chemical and toxic nature of these compounds remains to be determined, including their clinical implications at blood recycling in cardiac surgery.
Place, publisher, year, edition, pages
2010. Vol. 44, no 5, 307-312 p.
Cardiac surgery, electrocautery, fatty acid, decomposition, fat embolization, lipid
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-134096DOI: 10.3109/14017431.2010.491553ISI: 000283763500009OAI: oai:DiVA.org:uu-134096DiVA: diva2:374384