Systemic leukocyte filtration during cardiopulmonary bypass
| Autor: | Maria Rosa Carta, Giuliano Soffiati, Giuseppe Nardon, Jacopo Manfredi, Caterina Piccin, Alessandro Fabbri, Edoardo Gasparotto |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Neutrophils 030204 cardiovascular system & hematology law.invention Pulmonary function testing 03 medical and health sciences Leukocyte Count 0302 clinical medicine law Fraction of inspired oxygen Internal medicine medicine Cardiopulmonary bypass Leukocytes Humans Radiology Nuclear Medicine and imaging Leukapheresis Aged Advanced and Specialized Nursing Body surface area Inflammation Lung Ejection fraction Cardiopulmonary Bypass Pancreatic Elastase business.industry General Medicine Middle Aged Respiratory Function Tests medicine.anatomical_structure 030228 respiratory system Cardiology Arterial blood Female Cardiology and Cardiovascular Medicine business Safety Research Filtration Artery |
| Zdroj: | Perfusion. |
| ISSN: | 0267-6591 |
| Popis: | 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: 6.4 109/l ± 1.4×109/l in group F vs 10.3 ± 1.8×109/l in group C (p 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 (PaO2/FiO2 x 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. |
| Databáze: | OpenAIRE |
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