Leukocyte depletion during cardiac surgery with extracorporeal circulation in high risk patients.
Inflamm Res
; 57(12): 577-85, 2008 Dec.
Article
em En
| MEDLINE
| ID: mdl-19109738
BACKGROUND: Cardiopulmonary bypass is associated with systemic inflammation that may contribute to increased perioperative mortality. Depletion of circulating leukocytes may reduce the inflammatory response. We studied the effect of a leukocyte depleting filter on leukocyte activation during cardiopulmonary bypass in high risk patients. METHODS: Fifty patients undergoing coronary artery bypass grafting with a preoperative high risk were randomly placed in an arterial line leukocyte filter group (n = 25) with a leukocyte depleting filter. Blood sampling took place from the arterial line to analyze polymorphnuclear elastase and myeloperoxidase at six time points, including: A) before the induction of anesthesia, B) before the induction of the cardiopulmonary bypass C) 1 min after the release of the aorta clamp, D) the end of the operation, E) 1 h postoperative, and F) 24 h postoperative. RESULTS: Levels of polymorphonuclear elastase, (PMNE), and myeloperoxidase (MPO) were found to be higher after the release of the aortic cross clamp in the leukocyte filter group; these levels remained elevated until 24 hours after surgery and were high in comparison to preoperative baseline levels. The differences in PMNE between both groups at time points C and D (p < 0.005) and E (p < 0.05) were statistically significant. The serum levels of the S-100B and neuron specific enolase (NSE) were found to be elevated between time points C and E in both groups without statistical significance. The in-hospital mortality was 16% (4 patients) in leukocyte filter group and 4% in control group (1 patient). CONCLUSIONS: Interestingly, the activation of neutrophils was more pronounced in the LF group. The use of a leucocyte depleting filter was not advantageous for this patient cohort for clinical or biomedical endpoints.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Procedimentos de Redução de Leucócitos
/
Circulação Extracorpórea
/
Procedimentos Cirúrgicos Cardíacos
/
Inflamação
/
Leucócitos
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
Inflamm Res
Assunto da revista:
ALERGIA E IMUNOLOGIA
/
PATOLOGIA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Alemanha