Depletion of neutrophils by filter during aortocoronary bypass surgery transiently improves postoperative cardiorespiratory status.
OBJECTIVE
To determine whether inclusion of a leukocyte specific filter into the extracorporeal circuit during aortocoronary bypass surgery alters postoperative cardiopulmonary function.


METHODS
Randomized, double-blinded control trial.


METHODS
Tertiary care hospital.


METHODS
Convenience sampling of patients undergoing elective aortocoronary bypass between October 1992 and June 1993.


METHODS
A total of 32 patients were randomized to a leukocyte specific filter (n = 16) or to a standard blood filter (n = 16) during the surgical procedure.


RESULTS
White blood cell count in the standard filter group (12.2 +/- 3.6 10(9)/L) was higher (p = 0.047) than in the leukocyte filter group (9.9 +/- 2.6 10(9)/L) at 4 h postoperatively but counts were similar (p = 0.063) at 24 h (10.8 +/- 2.7 vs 8.9 +/- 2.6 10(9)/L, respectively). Leukocyte activation assessed by chemiluminescence was similar between groups at all measurement periods. We noted transient improvements (p < 0.05) in intrapulmonary shunt (19 +/- 50% vs 24 +/- 9%) and mean blood pressure (85 +/- 8 vs 76 +/- 9 mm Hg, respectively) in the leukocyte filter group compared with the standard filter group, respectively. Otherwise there were no differences noted between groups.


CONCLUSIONS
Inclusion of a leukocyte filter during cardiopulmonary bypass caused transient cardiorespiratory improvement that was lost within 24 h and did not offer any significant clinical benefits.
Johnson
D
D
Department of Anesthesia, University of Saskatchewan, Saskatoon, Canada.
Thomson
D
D
Mycyk
T
T
Burbridge
B
B
Mayers
I
I
D000368:Aged; D001772:Blood Cell Count; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005260:Female; D005374:Filtration / Q000295:instrumentation; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011184:Postoperative Period; D015656:Respiratory Mechanics
D006454:Hemoglobins; D015850:Interleukin-6