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Polymeric micro- and nanoparticle release from cardiopulmonary bypass and extracorporeal membrane oxygenation circuits.
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Researchers circulated saline through cardiopulmonary bypass and ECMO circuits for up to seven days and used micro-Raman spectroscopy to identify PVC, PMMA, PET, polyethylene, and polystyrene particles released into the perfusate, finding that particle counts and size range increased progressively over time—raising concern that patients receiving extracorporeal life support are exposed to polymeric microparticles from the circuits themselves.
OBJECTIVES: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) or life support (ECLS) circuits are built from polymers and might release polymeric micro- and nanoparticles (MNP) into the circulation. MNPs seem to provoke inflammation, oxidative stress, and apoptosis, which are also side effects of extracorporeal circulation. Thus, we investigated the MNP release from CPB and ECMO/ECLS circuits. METHODS: A CPB and ECMO/ECLS circuit was filled with saline solution, and circulation was initiated for 5 h and 7 d, respectively. Samples were taken from both circuits and filtered through a silicon membrane. MNPs were detected and quantified using optical microscopy and micro Raman spectroscopy. RESULTS: During circulation, polyvinyl chloride (PVC) and polymethyl methacrylate (PMMA) were detected in the CPB perfusate. After 5 h of circulation, polyethylene terephthalate (PET) was detected. In the ECMO/ECLS circuit, time-dependent accumulation of polymeric fragments was detected. Finally, particles of polyethylene (PE), polystyrene (PS), PET, and PVC were identified. The particle-size distribution extended from initially <2 µm to finally >10 µm with increasing circulation time. CONCLUSIONS: CPB and ECMO/ECLS circuits release MNPs. The number of MNPs increases over the period of use. A larger number of circuits and of health effects of identified MNPs, should be investigated.
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