Detrimental Effects of Particulate Matter on the Pulmonary Circulation

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Abstract
To the Editor.— 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 Hospital2,3has 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

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