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