Detrimental Effects of Particulate Matter on the Pulmonary Circulation

Abstract

<h3>To the Editor.—</h3> The communication by Shapiro et al¹concerning fatal drug reactions among medical inpatients reports four deaths that resulted from fluid overload (pulmonary edema). We would like to point out another possible cause-effect relationship that may be responsible for the pulmonary edema. A two-year ongoing study of commercially available infusion fluids at Temple University Hospital^2,3has revealed infusion fluids to contain a significant amount of foreign material (particulate matter). Analysis of over 1,000 commercially available solutions has revealed a content of foreign particles (glass, rubber, plastic, etc) of size above 5μ on the order of 100 particles/liter for one supplier. Two other suppliers had average particle counts of approximately 350 particles/liter. Over 1,-500 particles/liter were discovered in solutions of a fourth manufacturer. Although the clinical significance and the biological effects of these particles is unclear, some reports speculating on their clinical significance have appeared in the