title: Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass reduces myocardial injury.
abstract: Improved myocardial protection and cardiopulmonary bypass (CPB) have limited, but not abolished, intraoperative myocardial damage due to surgical reperfusion injury after release of the aortic crossclamp. In this double-blind, randomized study, we evaluated whether short-term leukocyte filtration during reperfusion may further reduce myocardial damage. Thirty-eight patients with coronary artery disease were randomly assigned to CPB with (group I; n = 19) or without leukocyte filtration (group II; n = 19). There was no difference in bypass time or crossclamp time between the groups. No patient in group I required catecholamines, whereas three patients in group II were supported with adrenaline or dobutamine on the first and second postoperative day. In addition, troponin T plasma levels were lower in group I (p < 0.05), whereas other markers for tissue injury (CK, CK-MB, LDH, S-GOT and S100B) did not differ. In conclusion, leukocyte filtration during reperfusion may further improve CPB by reducing myocardial damage.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt, Germany. matheis.gbr@gmx.de
authors.forename: G
authors.initials: G
authors.lastname: Matheis
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.forename: J
authors.initials: J
authors.lastname: Gerber
authors.forename: U
authors.initials: U
authors.lastname: Abdel-Rahman
authors.forename: G
authors.initials: G
authors.lastname: Wimmer-Greinecker
authors.forename: A
authors.initials: A
authors.lastname: Moritz
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers; D001780:Blood Coagulation Tests; D001798:Blood Proteins / Q000032:analysis; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation; D002395:Catecholamines / Q000627:therapeutic use; D002408:Catheters, Indwelling; D003131:Combined Modality Therapy; D015938:Complement Membrane Attack Complex / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D004280:Dobutamine / Q000627:therapeutic use; D004311:Double-Blind Method; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005374:Filtration; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D007432:Intraoperative Period; D007527:Isoenzymes / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007962:Leukocytes; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000517:prevention & control*; D018384:Oxidative Stress; D010865:Pilot Projects; D011184:Postoperative Period; D020107:Troponin T / Q000097:blood
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D001798:Blood Proteins; D002395:Catecholamines; D015938:Complement Membrane Attack Complex; D007527:Isoenzymes; D020107:Troponin T; D004280:Dobutamine; D006493:Heparin; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase; D004837:Epinephrine