Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass reduces myocardial injury.
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.
Matheis
G
G
Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt, Germany. matheis.gbr@gmx.de
Scholz
M
M
Gerber
J
J
Abdel-Rahman
U
U
Wimmer-Greinecker
G
G
Moritz
A
A
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
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