TITLE

Systemic leukocyte filtration during cardiopulmonary bypass

AUTHOR(S)
Fabbri, A.; Manfredi, J.; Piccin, C.; Soffiati, G.; Carta, M.; Gasparotto, E.; Nardon, G.
PUB. DATE
March 2001
SOURCE
Perfusion;Mar2001 Supplement 1, Vol. 16, p11
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Cardiopulmonary bypass (CPB) induces a whole body inflammatory response leading to postoperative lung dysfunction. Activated leukocytes may play a role in the pathogenesis of pulmonary dysfunction. We evaluated postoperative lung function after the use of leukocyte-depleting filters incorporated in the extracorporeal circuit during CPB. From November 1997 to March 2000, 40 patients underwent isolated coronary artery bypass grafting. Patients were randomly allocated to the leukocyte-depletion group (group F, 20 patients) or to the control group (group C, 20 patients). There was no significant difference between the two groups with respect to age, sex, weight, height, body surface area, haemoglobin and haematocrit levels, preoperative left ventricular ejection fraction, cooling temperature, aortic crossclamping and CBP duration. Blood samples were drawn preoperatively, at aortic declamping, 60 min after CPB, after arriving at the intensive care unit (ICU) and 24 h after the operation. We analysed blood cell count, elastase, interleukin-8 (IL-8) and tumour necrosis factor (TNF-α) levels and continuous monitoring of arterial blood gases in the intensive care unit (ICU). The analysis of total circulating white blood cells (WBCs) showed a significant reduction of WBCs in both groups soon after aortic declamping [from the right atrium: 6.4 × 10[sup 9]/l ± 1.4 × 10[sup 9]/l in group F vs 10.3 ± 1.8 × 10[sup 9]/l in group C (p<0.05); from the left atrium: 5.8 ± 1.3 × 10[sup 9]/l in group F vs 8.4 ± 1.9 × 10[sup 9]/l in group C (p<0.05)] and after 60 min of CPB [7.1 ± 2.2 × 10[sup 9]/l in group F vs 10.4 ± 1.8 × 10[sup 9]/l in group C (p<0.05)]. The analysis of circulating neutrophils showed similar findings in both groups. Elastase levels increased during CPB in both groups with a peak at the end of CPB without significant difference between the two groups (group C: 260 ± 148 μg/l vs group F: 371 ± 68 μg/l). The decrease of plasmatic elestase levels was observed, for both groups, in the 24 h after CPB. There was no difference in intubation time between the two groups (16.4 h for group C vs 11.2 h for group F). Pulmonary function tested by pulmonary respiratory index [RI = partial pressure of oxygen/fraction of inspired oxygen (PaO[sub 2]/FiO[sub 2] × 100)] did not show significant difference between the two groups, either arriving in the ICU (group C RI 265 vs group F RI 322), or after 3 h (group RI 304 vs group F RI 305) or after 6 h (group C RI 292 vs group F RI 319). Leukocyte-depleting filters reduce with blood cells count during CPB, but, in this study, WBC depletion did not significantly improve clinical conditions or laboratory finding.
ACCESSION #
5174045

 

Related Articles

  • Clinical benefits of continuous leukocyte filtration during cardiopulmonary bypass in patients undergoing valvular repair or replacement. Sutton, S. W.; Patel, A. N.; Chase, V. A.; Schmidt, L. A.; Hunley, E. K.; Yancey, L. W.; Hebeler, R. F.; Cheung, E. H.; Henry III, A. C.; Meyers, T. P.; Wood, R. E. // Perfusion;Jan2005, Vol. 20 Issue 1, p21 

    Valve operations in the form of repair or replacement make up a significant population of patients undergoing surgical procedures in the USA annually with the use of cardiopulmonary bypass. These patients experience a wide range of complications that are considered to be mediated by activation...

  • Timing of leukocyte filtration during cardiopulmonary bypass. Matheis, G.; Scholz, M.; Simon, A.; Henrich, D.; Wimmer-Greinecker, G.; Moritz, A. // Perfusion;Mar2001 Supplement 1, Vol. 16, p31 

    The effects of leukocyte filtration on the outcome of cardiac surgery with cardiopulmonary bypass (CPB) have been shown by numerous investigators. In the majority of cases a leukocyte filter is placed in the arterial line instead of a standard arterial line filter and used throughout CPB....

  • A clinical comparison of bubble elimination in Quadrox and Polystan oxygenators. Jirschik, Mario; Keyl, Cornelius; Beyersdorf, Friedhelm // Perfusion;Nov2009, Vol. 24 Issue 6, p423 

    Background: Microbubbles generated during heart surgery on extracorporeal circulation have been implicated as a possible cause of postoperative neurocognitive dysfunction and negative outcome. The main sources of microbubbles in the extracorporeal circuit are air leaking from the venous...

  • The effects of leucodepletion in patients who develop the systemic inflammatory response syndrome following cardiopulmonary bypass. Treacher, D.; Sabbato, M.; Brown, K.; Gant, V. // Perfusion;Mar2001 Supplement 1, Vol. 16, p67 

    The development of the systemic inflammatory response syndrome (SIRS) is associated with increased morbidity and mortality. Numerous anticytokine trials have failed to demonstrate any outcome benefit and there has been little evidence of improvement in the prognosis of this condition over the...

  • Editorial. Taylor, K. // Perfusion;1999, Vol. 14 Issue 5, p319 

    Editorial. Discusses the introduction of computer control systems into the cardio-pulmonary bypass circuit; Views on mathematical modelling of extracorporeal circulation; Evolution of automated control systems.

  • An update on perfusion safety: does the type of perfusion practice affect the rate of incidents related to cardiopulmonary bypass? Stammers, A.H.; Mejak, B.L. // Perfusion;May2001, Vol. 16 Issue 3, p189 

    Cardiopulmonary bypass (CPB) techniques vary among adult and pediatric patients undergoing cardiac surgery. This may result in a differential conduct of CPB between various aged patients. The present study reports on perfusion incidents occurring in hospitals using extracorporeal circulation. An...

  • Vacuum-assisted venous return in pediatric cardiopulmonary bypass. Berryessa, R.; Wiencek, R.; Jacobson, J.; Hollingshead, D.; Farmer, K.; Cahill, G. // Perfusion;Jan2000, Vol. 15 Issue 1, p63 

    Vacuum-assisted venous return (VAVR) has been reported to offer benefits for adults undergoing cardiopulmonary bypass (CPB), such as improved venous return, lowering priming volume (by eliminating the need to prime the venous line), and the use of smaller venous cannulae. All these benefits...

  • Affinity pump system: a new peristaltic blood pump for cardiopulmonary bypass. Jaggy, C.; Lachat, M.; Leskosek, B.; Zünd, G.; Turina, M. // Perfusion;Jan2000, Vol. 15 Issue 1, p77 

    An in vitro study has been carried out to assess the pump performance of a new peristaltic, extracorporeal displacement pump (Affinity) for cardiopulmonary bypass. The pump system consists of a pump rotor (0--110 rpm), a pump chamber, a venous reservoir with a 5/8 connecting tube and the...

  • Leukocyte removal efficiency of cell-washed and unwashed whole blood: an in vitro study. ten Brinke, M. J.; Weerwind, P. W.; Teerenstra, S.; Feron, J. C. M.; van der Meer, W.; Brouwer, M. H. J. // Perfusion;Nov2005, Vol. 20 Issue 6, p335 

    Leukocyte filtration of the cardiopulmonary bypass (CPB) perfusate after cardiac surgery has evolved as an important technique to prevent effector functions mediated by activated leukocytes. However, little is known about the filtration efficiency. Therefore, an in vitro study was conducted to...

Share

Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics