The rationale for fat filtration during cardiac surgery.

Improved filter technology may enable the removal of specific substances such as lipids from the blood. Lipids form a heterogeneous group of compounds, but during surgery, the main interest is focussed on triglycerides, glycerol and free fatty acids. Fat emboli have been demonstrated in the brain after cardiac surgery and are associated with ischaemic brain injury. Fat emboli have also been demonstrated in lung and kidney tissue. Lung tissue and leucocytes are especially vulnerable to the effects of free fatty acids. The surgical wound suction blood during cardiac surgery contains a considerable quantity of microemboli. Therefore, as a first step to determining the place of fat filtration during cardiac surgery, the use of a fat removal filter for surgical wound suction blood is advocated.