Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass reduces myocardial injury

Perfusion. 2001 Jan;16(1):43-9. doi: 10.1177/026765910101600107.

Abstract

Improved myocardial protection and cardiopulmonary bypass (CPB) have limited, but not abolished, intraoperative myocardial damage due to surgical reperfusion injury after release of the aortic crossclamp. In this double-blind, randomized study, we evaluated whether short-term leukocyte filtration during reperfusion may further reduce myocardial damage. Thirty-eight patients with coronary artery disease were randomly assigned to CPB with (group I; n = 19) or without leukocyte filtration (group II; n = 19). There was no difference in bypass time or crossclamp time between the groups. No patient in group I required catecholamines, whereas three patients in group II were supported with adrenaline or dobutamine on the first and second postoperative day. In addition, troponin T plasma levels were lower in group I (p < 0.05), whereas other markers for tissue injury (CK, CK-MB, LDH, S-GOT and S100B) did not differ. In conclusion, leukocyte filtration during reperfusion may further improve CPB by reducing myocardial damage.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anticoagulants / pharmacology
  • Aspartate Aminotransferases / blood
  • Biomarkers
  • Blood Coagulation Tests
  • Blood Proteins / analysis
  • Cardiopulmonary Bypass / adverse effects*
  • Cardiopulmonary Bypass / instrumentation
  • Catecholamines / therapeutic use
  • Catheters, Indwelling
  • Combined Modality Therapy
  • Complement Membrane Attack Complex / analysis
  • Creatine Kinase / blood
  • Dobutamine / therapeutic use
  • Double-Blind Method
  • Epinephrine / therapeutic use
  • Female
  • Filtration
  • Heparin / pharmacology
  • Humans
  • Intraoperative Period
  • Isoenzymes / blood
  • L-Lactate Dehydrogenase / blood
  • Leukocytes*
  • Lymphocyte Depletion / methods*
  • Male
  • Middle Aged
  • Myocardial Reperfusion Injury / blood
  • Myocardial Reperfusion Injury / prevention & control*
  • Oxidative Stress
  • Pilot Projects
  • Postoperative Period
  • Troponin T / blood

Substances

  • Anticoagulants
  • Biomarkers
  • Blood Proteins
  • Catecholamines
  • Complement Membrane Attack Complex
  • Isoenzymes
  • Troponin T
  • Dobutamine
  • Heparin
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Creatine Kinase
  • Epinephrine