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Air contamination during medical treatment results in deposits of microemboli in the lungs: an autopsy study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-3581-5678
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0003-2694-7035
2019 (English)In: International Journal of Artificial Organs, ISSN 0391-3988, E-ISSN 1724-6040, Vol. 42, no 9, p. 477-481Article in journal (Refereed) Published
Abstract [en]

Introduction: Microbubbles of air may enter into patients during conventional hemodialysis, infusions of fluids, or by injections. The aim of this study was to investigate whether the air that enters the patient during hemodialysis can be detected in the lungs after death, and if so, whether this may be related to tissue damage. Methods: The material consisted of lung tissue from five chronic hemodialysis patients who died either during (two) or after hemodialysis (range 10 min from start until 3333 min after the last hemodialysis session); as reference group tissue was taken from seven patients who died due to amyotrophic lateral sclerosis. The lung tissue was investigated by microscopy after autopsy using a fluorescein-marked polyclonal antibody against fibrinogen as a marker for clots preformed before death. Results: All five hemodialysis patients had microbubbles of air in the lung tissue, whereas two of seven amyotrophic lateral sclerosis patients had such findings (Fisher's test p = 0.0278, relative risk = 3.5, confidence interval: 1.08-11.3). There were more microbubbles of air/10 randomly investigated microscopic fields of tissue in the hemodialysis patients than the amyotrophic lateral sclerosis patients (Student's test, p < 0.05). All hemodialysis patients had a medium graded extent of pulmonary fibrosis that was not found in any of the ALS patients. The microbubbles of air were surrounded by fibrin as a sign of development of clots around the air bubbles while the patients were still alive. Conclusion: Exposure to microbubbles of air during various treatments such as hemodialysis may result in microemboli. Future studies should clarify whether microbubbles of air contribute to tissue scarring. We suggest preventive measures against the exposure to microbubbles of air during especially repeated exposures such as hemodialysis.

Place, publisher, year, edition, pages
Sage Publications, 2019. Vol. 42, no 9, p. 477-481
Keywords [en]
Microbubbles, microemboli, hemodialysis, pulmonary fibrosis, air bubbles
National Category
Biomedical Laboratory Science/Technology Other Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-162833DOI: 10.1177/0391398819840363ISI: 000480759400001PubMedID: 30973284OAI: oai:DiVA.org:umu-162833DiVA, id: diva2:1351119
Available from: 2019-09-13 Created: 2019-09-13 Last updated: 2019-09-13Bibliographically approved

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Forsberg, UlfJonsson, PerStegmayr, Bernd

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