Myocardial protective effect of leukocyte-depleted blood perfusion during open heart surgery / 中华麻醉学杂志

ABSTRACT

Objective In addition to myocardial ischemia,massive inflammatory mediators and different enzymes are released and free radicals increase during cardiopulmonary bypass(CPB) due to the contact of blood with foregin material Leukocytes play an important role The purpose of this study was to evaluate the myocardial protective effect of leukocyte depleted blood perfusion during open heart surgery Methods Thirty adult ASA II IV patients scheduled for elective orthotopic valve replacement received fentanyl enflurane anesthesia A bolus of 3 mg/kg intravenous heparin was given before CPB Cardiac arrest was induced with 4 ℃ hyperkalemic crystalliod cardioplegic solution Patients were randomly allocated to one of 3 groups based on the types of cardioplegic solution used during CPB crystalloid solution(group CS, n=10),whole blood (group WB,n=10), and leukocyte depleted blood (group LD,n=10) Blood samples were taken from peripheral artery before heparinization, 5 min after initiation of CPB ,5 min before and 30 min, 1 h, 2 h and 24 h after declamping of aorta respectively for determinations of creatine kinase MB(CK MB), interleukin 8(IL 8) and tumor necrosis factor alpha(TNF?) Myocardial tissuses were obtained from right atrium before cross clamping of aorta, before and 15 min after declamping of aorta for determinations of water content,Ca 2+ content and ultrastructure examination of myocardium Results After declamping plasma concentrations of CK MB and IL 8 significantly increased in all groups as compared to the values before declamping (P