Depletion of activated neutrophils by a filter during cardiac valve surgery.
OBJECTIVE
To determine whether inclusion of a neutrophil-specific filter into the extracorporeal circuit during open heart valve surgery alters postoperative outcomes.


METHODS
Convenience sampling of 24 patients undergoing elective open heart valve surgery between July 1993 and June 1994. Patients were randomized to a neutrophil-specific filter (n = 11) or to a standard blood filter (n = 13) during cardiopulmonary bypass.


RESULTS
Neutrophil-specific filter diminished (P < 0.02) the expression of CD18, a neutrophil surface adhesion molecule, at I (84.5 +/- 4.2 vs 94.8 +/- 3.8%), 4 (80.0 +/- 4.2 vs 95.1 +/- 3.9%) and 24 hr (75.2 +/- 4.2 vs 98.2 +/- 3.9%) post-operatively compared with standard filter. Total white blood cell count, neutrophil count, and pro-inflammatory cytokines (IL-6, IL-8) were similar between groups at all times. Measured outcomes including: PaO2 cardiac index, ejection fraction, haemodynamic variables, use of inotropes, spirometry (FEV1, FVC), and hospitalization duration were similar between groups.


CONCLUSIONS
Inclusion of the neutrophil filter during open heart valve surgery selectively depletes activated neutrophils. There were no other detectable differences between the two groups and the use of a neutrophil-specific filter in routine clinical practice for patients undergoing open heart valve surgery is not supported.
Hurst
T
T
Department of Anaesthesia, University of Saskatchewan, Saskatoon, Canada.
Johnson
D
D
Cujec
B
B
Thomson
D
D
Mycyk
T
T
Burbridge
B
B
Mayers
I
I
D000328:Adult; D000368:Aged; D018821:CD18 Antigens / Q000032:analysis; D002315:Cardiopulmonary Bypass; D002448:Cell Adhesion; D016207:Cytokines / Q000032:analysis; D005260:Female; D005374:Filtration; D006351:Heart Valves / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation; D009504:Neutrophils / Q000502:physiology*; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange
D018821:CD18 Antigens; D016207:Cytokines