Über die histologische Differenzierung von Fettembolie und Silikonembolie nach extrakorporalem Kreislauf mit dem Beuteloxygenator

Abstract

Introduction An attempt has been made to distinguish histologically fat embolism from silicone antifoam compound embolism occurring after extracorporeal circulation with the bubble oxygenerator (Clark, DeWall, Rygg-Kyvsgaard). Material and Methods 20 μ thick formalin fixed frozen sections from human brain and kidney were stained with hemalum-Sudan III, oil red O, Sudan black, nuclear fast red and hematoxylin-eosin. Some frozen sections were extracted with cold acetone and subsequently stained with Sudan III. Silicone antifoam compound was injected post mortem into arteries of brain and kidney. Frozen sections were prepared. Small pieces of brain and kidney were examined physico-chemically for content of Silicone antifoam compound. Slides ware examined at medium magnification using a small aperture of illumination (top lens of condensor turned out, diaphragm half closed). Results and Discussion Fat emboli measuring 10–15 μ in diameter and 15–60 μ in length and staining red with Sudan III were found in capillaries of cerebral cortex (Fig. 1) and glomeruli (Fig. 2). They were extractable with cold acetone. Silicone emboli measuring 10–20 μ in diameter and up to 90 μ in length were visible in capillaries of the same localization (Fig. 3 and 4). They did not take the Sudan III dye and remained transparent with a small dark margin. Cold acetone did not remove them from tissue sections. Microscopic examination of organs after intraarterial injection of Silicone antifoam compound (Fig. 5) and infrared spectrographical analysis of organ extracts prepared by chromatography (Fig. 6) support the above histological differentiation (Table 1).