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Plasma lipids during extracorporeal circulation.

P Ghirardi, A Marzo, C Rossi

    The Journal of Thoracic and Cardiovascular Surgery
    |October 1, 1975
    PubMed
    Summary
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    Extracorporeal circulation (ECC) hemodilution causes a drop in plasma lipids. Increased free fatty acids (FFA) correlate with decreased triglycerides, likely due to heparin-stimulated lipase lipoproteic (LLP) activity, not fat stores.

    Area of Science:

    • Biochemistry
    • Cardiovascular Surgery
    • Lipid Metabolism

    Background:

    • Extracorporeal circulation (ECC) is a critical procedure in cardiac surgery.
    • Understanding lipid dynamics during ECC is essential for patient management.
    • Hemodilution during ECC significantly impacts plasma composition.

    Purpose of the Study:

    • To investigate changes in total lipids, lipid classes, and fatty acid composition in plasma and subcutaneous fat during ECC.
    • To determine the relationship between different lipid components during ECC.
    • To explore the source of free fatty acids (FFA) during ECC.

    Main Methods:

    • Analysis of total lipids, lipid classes, and fatty acid composition.
    • Sampling of plasma and subcutaneous fat from 19 subjects before and at intervals during ECC.

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  • Statistical evaluation of lipid variations, accounting for hemodilution effects.

    • Main Results:

    • Hemodilution led to a general decrease in total lipids and lipid classes.
    • After correcting for hemodilution, a linear correlation was observed between increased free fatty acids (FFA) and decreased triglycerides.
    • The study discounted the hypothesis that FFA were mobilized from stored subcutaneous fats.

    Conclusions:

    • Heparin administration during ECC stimulates lipase lipoproteic (LLP) activity.
    • This stimulated LLP activity is the primary driver for the observed increase in FFA and decrease in triglycerides.
    • Subcutaneous fat stores are not the source of increased FFA during ECC.