Systemic leukocyte filtration during cardiopulmonary bypass

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...

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Veröffentlicht in:Perfusion 2001, Vol.16 (1_suppl), p.11-18
Hauptverfasser: Fabbri, Alessandro, Manfredi, Jacopo, Piccin, Caterina, Soffiati, Giuliano, Carta, Maria Rosa, Gasparotto, Edoardo, Nardon, Giuseppe
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container_end_page 18
container_issue 1_suppl
container_start_page 11
container_title Perfusion
container_volume 16
creator Fabbri, Alessandro
Manfredi, Jacopo
Piccin, Caterina
Soffiati, Giuliano
Carta, Maria Rosa
Gasparotto, Edoardo
Nardon, Giuseppe
description 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
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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&lt;0.05); from the left atrium: 5.8 ± 1.3×109/l in group F vs 8.4 ± 1.9×109/l in group C (p&lt;0.05)] and after 60 min of CPB [7.1 ± 2.2×109/l in group F vs 10.4 ± 1.8×109/l in group C (p&lt;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 (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.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/026765910101600i103</identifier><identifier>PMID: 11334202</identifier><language>eng</language><publisher>Thousand Oaks, CA: SAGE Publications</publisher><subject>Aged ; Aorta ; Atrium ; Blood ; Blood circulation ; Bypasses ; Cardiopulmonary Bypass - adverse effects ; Cardiopulmonary Bypass - methods ; Cooling ; Coronary artery ; Depletion ; Elastase ; Female ; Filters ; Filtration ; Gases ; Heart ; Heart surgery ; Hematocrit ; Hemoglobin ; Humans ; Inflammation ; Inflammation - etiology ; Inflammation - prevention &amp; control ; Inflammatory response ; Intensive care ; Interleukin 8 ; Interleukins ; Intubation ; Leukapheresis ; Leukocyte Count ; Leukocytes ; Leukocytes (neutrophilic) ; Lungs ; Male ; Middle Aged ; Neutrophils - cytology ; Oxygen ; Pancreatic Elastase - blood ; Partial pressure ; Pathogenesis ; Patients ; Respiratory function ; Respiratory Function Tests ; Temperature effects ; Time Factors ; Tumor necrosis factor ; Tumor necrosis factor-TNF ; Tumors ; Ventricle</subject><ispartof>Perfusion, 2001, Vol.16 (1_suppl), p.11-18</ispartof><rights>Copyright Sage Publications Ltd. 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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. 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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.</description><subject>Aged</subject><subject>Aorta</subject><subject>Atrium</subject><subject>Blood</subject><subject>Blood circulation</subject><subject>Bypasses</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Cooling</subject><subject>Coronary artery</subject><subject>Depletion</subject><subject>Elastase</subject><subject>Female</subject><subject>Filters</subject><subject>Filtration</subject><subject>Gases</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Hematocrit</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inflammation - etiology</subject><subject>Inflammation - prevention &amp; control</subject><subject>Inflammatory response</subject><subject>Intensive care</subject><subject>Interleukin 8</subject><subject>Interleukins</subject><subject>Intubation</subject><subject>Leukapheresis</subject><subject>Leukocyte Count</subject><subject>Leukocytes</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lungs</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neutrophils - cytology</subject><subject>Oxygen</subject><subject>Pancreatic Elastase - blood</subject><subject>Partial pressure</subject><subject>Pathogenesis</subject><subject>Patients</subject><subject>Respiratory function</subject><subject>Respiratory Function Tests</subject><subject>Temperature effects</subject><subject>Time Factors</subject><subject>Tumor necrosis factor</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumors</subject><subject>Ventricle</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp90ctKxDAYBeAgijOOPoEgRUFX1dzT4EoGbzDgQgV3JU3TIWNvJu2ib2_qDCiiQxbZfOfk8gNwjOAlQkJcQcwFZxLBsDiEFkGyA6aIChEjhN52wXQU8Ugm4MD7FYSQUkr2wQQhQiiGeAqunwffmcrqqDT9e6OHzkSFLTunOtvUUd47Wy8jrVxum7Yvq6ZWboiyoVXeH4K9QpXeHG32GXi9u32ZP8SLp_vH-c0i1hTLLkbUyIwxQRDBMssVw4QlXBV5AQnnWkpGNKO5LghmpIAG50JrSbMkRHKBEzIDF-ve1jUfvfFdWlmvTVmq2jS9TwXlmGAhR3m-XcIEU8pJgKe_4KrpXR1ekaJwISbxFzr7FyUJ4wlNEA-KrJV2jffOFGnrbBV-KUUwHQeV_jGokDrZdPdZZfLvzGYyAcA18Gppfhy8pfMTfWKZgw</recordid><startdate>2001</startdate><enddate>2001</enddate><creator>Fabbri, Alessandro</creator><creator>Manfredi, Jacopo</creator><creator>Piccin, Caterina</creator><creator>Soffiati, Giuliano</creator><creator>Carta, Maria Rosa</creator><creator>Gasparotto, Edoardo</creator><creator>Nardon, Giuseppe</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>2001</creationdate><title>Systemic leukocyte filtration during cardiopulmonary bypass</title><author>Fabbri, Alessandro ; Manfredi, Jacopo ; Piccin, Caterina ; Soffiati, Giuliano ; Carta, Maria Rosa ; Gasparotto, Edoardo ; Nardon, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c429t-14e9b55731329bda523586afdf0366c9953c54dcf3253f0e2d7cc94b8573d7283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Aorta</topic><topic>Atrium</topic><topic>Blood</topic><topic>Blood circulation</topic><topic>Bypasses</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Cooling</topic><topic>Coronary artery</topic><topic>Depletion</topic><topic>Elastase</topic><topic>Female</topic><topic>Filters</topic><topic>Filtration</topic><topic>Gases</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Hematocrit</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Inflammation - etiology</topic><topic>Inflammation - prevention &amp; 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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&lt;0.05); from the left atrium: 5.8 ± 1.3×109/l in group F vs 8.4 ± 1.9×109/l in group C (p&lt;0.05)] and after 60 min of CPB [7.1 ± 2.2×109/l in group F vs 10.4 ± 1.8×109/l in group C (p&lt;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 (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.</abstract><cop>Thousand Oaks, CA</cop><pub>SAGE Publications</pub><pmid>11334202</pmid><doi>10.1177/026765910101600i103</doi><tpages>8</tpages></addata></record>
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subjects Aged
Aorta
Atrium
Blood
Blood circulation
Bypasses
Cardiopulmonary Bypass - adverse effects
Cardiopulmonary Bypass - methods
Cooling
Coronary artery
Depletion
Elastase
Female
Filters
Filtration
Gases
Heart
Heart surgery
Hematocrit
Hemoglobin
Humans
Inflammation
Inflammation - etiology
Inflammation - prevention & control
Inflammatory response
Intensive care
Interleukin 8
Interleukins
Intubation
Leukapheresis
Leukocyte Count
Leukocytes
Leukocytes (neutrophilic)
Lungs
Male
Middle Aged
Neutrophils - cytology
Oxygen
Pancreatic Elastase - blood
Partial pressure
Pathogenesis
Patients
Respiratory function
Respiratory Function Tests
Temperature effects
Time Factors
Tumor necrosis factor
Tumor necrosis factor-TNF
Tumors
Ventricle
title Systemic leukocyte filtration during cardiopulmonary bypass
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