Korean J Thorac Cardiovasc Surg.
2001 Jun;34(6):454-464.
The Clinical Effects of Leukocyte-Depleting Filter on Cardiopulmonary Bypass
- Affiliations
-
- 1Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University.
- 2Laboratory of Extracorporeal circulation, Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje
University.
- 3Department of Data Science, Inje University.
- 4Seorabul clinic, Ulsan city.
- 5Department of Emergency medicine, Pusan Paik Hospital, College of Medicine, Inje University.
Abstract
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BACKGROUND: It has been recognized that systemic inflammatory reaction and oxygen free
radical formed by activated leukocyte in the procedure of cardiopulmonary bypass(CPB)
frequently produce postoperative cardiac and pulmonary dysfunction. The purpose of this
study was to evaluate the efficacy of leukocyte-depleting filters in the cardiopulmonary
bypass circuit for patients undergoing open heart surgery(OHS).
MATERIAL AND METHOD: The
study involved 15 patients who underwent OHS with a Leukoguard-6 leukocyte filter placed
in the arterial limbs of the bypass circuit(filter group, n=15) and 15 patients who did not
have the filter(control group, n=15). We analyzed the differences between the groups in
intraoperative changes of peripheral blood leukocyte and platelet counts, pre- and postbypass
changes of malondialdehyde(MDA), troponin-T(TnT), 5'-nucleotidase(5'-NT) in coronary sinus
blood, spontaneous recovery rate of heart beat after CPB, pre-and postoperative cardiac
index(CI) and pulmonary vascular resistance(PVR), and the amounts of postoperative
bleeding and sternal wound complication.
RESULT: During CPB, total leukocyte count of the
filter group(9,567 +/- 842/mm3) was significantly less than that of the control group(13,573 +/-
1,167/mm3) (p<0.01), but there was no significant difference in platelet count between the
groups. Postoperative levels of MDA(3.78 +/- 0.32 micromole/L vs 5.86 +/- 0.65 micromole/L, p<0.01),
TnT(0.40 +/- 0.04 ng/mL vs 0.59 +/- 0.08 ng/mL, p<0.05) and 5'-NT(3.88 +/- 0.61 U/L vs 5.80 +/- 0.90 U/L, p<0.05) were all significantly lower in the filter group than the control group. Postoperative CI was higher in the filter group than the control group(3.26 +/- 0.18 L/m2/min vs 2.75 +/- 0.17 L/m2/min, p=0.05). PVR of the filter group was lower than that of the control group(65.87 +/- 7.59 dyne/sec/cm5 vs 110.80 +/- 12.22 dyne/sec/cm5, p<0.01). Spontaneous recovery rate of heart beat in the filter group was higher than that in the control group(12 patients vs 8 patients, p<0.05). Postoperative wound infection occurred in one case in the filter group and 4 case in the control group(p<0.05). Postoperative 24 hour blood loss of the filter group was more than that of the control group (614 +/- 107 mL vs 380 +/- 71 mL, p=0.05).
CONCLUSION
These data suggest that the leukocyte-depleting filter has beneficial effects on postoperative cardiac and pulmonary functions with diminution of reperfusion injury. However, bleeding tendency at early postoperative period is higher in the filter group than the control group and thus the further studies seem to be necessary at this point.