title: Prevention of remote organ injury in cardiopulmonary bypass: the impact of flow generation technique.
abstract: The purpose of this study was to investigate the effects of 3 different types of flow generation for cardiopulmonary bypass on gastrointestinal permeability and on neutrophil expression of CD11b, a surface marker of neutrophil activation. Fourteen patients undergoing elective coronary revascularization were selected randomly to receive 1 of the 3 flow generation techniques (roller, pulsatile, or centrifugal). Intestinal permeability was assessed by the fraction of an oral dose of 51chromium-ethylenediaminetetraacetate (51Cr-EDTA) recovered in the urine over 24 h. Neutrophil activation was determined by expression of CD11b markers at 6 time points. Overall, the 14 patients showed significant increases in intestinal permeability. It was not possible to demonstrate statistically significant differences among the flow generation groups; however, when compared to both roller pump groups, the centrifugal pump group showed a 3.2% reduction in intestinal permeability. There was no change in the expression of CD11b receptors throughout the time points, nor was there a relationship of CD11b markers to the flow generation technique.
authors.affiliation: Department of Cardiothoracic Surgery, Queen Elizabeth Medical Center, United Kingdom.
authors.forename: J A
authors.initials: JA
authors.lastname: Hyde
authors.forename: D W
authors.initials: DW
authors.lastname: Riddington
authors.forename: P
authors.initials: P
authors.lastname: Hutton
authors.forename: I C
authors.initials: IC
authors.lastname: Wilson
authors.forename: C M
authors.initials: CM
authors.lastname: Boivin
authors.forename: G
authors.initials: G
authors.lastname: Nash
authors.forename: T R
authors.initials: TR
authors.lastname: Graham
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000592:standards; D002860:Chromium Radioisotopes; D001026:Coronary Artery Bypass; D004064:Digestive System / Q000503:physiopathology*; D004492:Edetic Acid / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics; D004562:Electrocardiography; D005260:Female; D006400:Hematocrit; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology; D007553:Isotope Labeling; D016177:Macrophage-1 Antigen / Q000096:biosynthesis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation / Q000502:physiology*; D009504:Neutrophils / Q000166:cytology / Q000378:metabolism*; D010539:Permeability; D011673:Pulsatile Flow
chemical_list: D002860:Chromium Radioisotopes; D016177:Macrophage-1 Antigen; D004492:Edetic Acid