Fat embolism due to cardiopulmonary bypass

Cardiopulmonary bypass has been implicated as a cause of fat enbolism resulting in pulmonary and cerebral complications. To determine whether cardiopulmonary bypass produces fat particles in the pulmonary circulation, 24 patients who underwent cardiopulmonary bypass for open-heart procedures were evaluated. Blood from the right atrium is sampled before, during and after cardiopulmonary bypass. The blood sanpies are centrifuged, stained, and examined microscopically. A statistically significant increase in the number and size of serum fat globules is noted during and immediately after medial division of the sternum. Of this group, 20 patients demonstrated fat embolization manifested by an increase in the number and size of the fat globules from one to three minutes following median sternotomy. These findings may account for some intraoperative as well as postoperative respiratory complications.