The role of leukocyte depletion in reducing injury to myocardium and lung during cardiopulmonary bypass.
Activated leukocytes and oxygen free radicals have been implicated in the pathogenesis of heart and lung injury after reperfusion and during cardiopulmonary bypass. This study was designed to determine whether leukocyte depletion prevents injury to the heart and lung during cardiopulmonary bypass. Twenty-eight open heart surgeries were performed in this study. In Group F, leukocyte depletion was performed with an LG-6 arterial line filter after aortic declamp (n = 14). Leukocyte depletion was not performed during cardiopulmonary bypass in Group C (n = 14). Thereafter, cardiac and lung function were assessed in the 24 hr after reperfusion. The total catecholamine dose used for 24 hr after reperfusion (r) was 61.9 +/- 13.4 in Group C and 43.9 +/- 19.2 in Group F (p < 0.05). CK-MB at 3 and 6 hr after reperfusion was 65.9 +/- 13.5 and 64.8 +/- 15.8 in Group C and 45 +/- 11.8 and 38 +/- 10.8 in Group F, respectively (p < 0.05). The pulmonary index after reperfusion at 3 and 6 hr was 1.7 +/- 0.5 and 1.3 +/- 0.4 in Group C and 0.7 +/- 0.3 and 0.6 +/- 0.4 in Group F, respectively (p < 0.05). There was significantly better preserved lung function in Group F. In conclusion, leukocyte depletion was significantly effective in preserving heart and lung function during cardiopulmonary bypass.
Hachida
M
M
Department of Cardiovascular Surgery, Heart Institute of Japan, Japan, Tokyo.
Hanayama
N
N
Okamura
T
T
Akasawa
T
T
Maeda
T
T
Bonkohara
Y
Y
Endo
M
M
Hashimoto
A
A
Koyanagi
H
H
D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007937:Leukapheresis; D007962:Leukocytes / Q000502:physiology*; D055370:Lung Injury; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D017382:Reactive Oxygen Species / Q000378:metabolism
D017382:Reactive Oxygen Species