Concentrated platelets harvesting before cardiopulmonary bypass improved cardiac and pulmonary function.
BACKGROUND
Sequestration of concentrated platelets (P-con) during cardiopulmonary bypass (CPB) has been performed to preserve platelet function after cardiac surgery. Since P-con also harvests leukocytes simultaneously, there might be a possibility that the inflammatory effects or ischemia-reperfusion injuries associated with CPB, such as a cardiac or pulmonary dysfunction after cardiac surgery, are reduced with its use.


METHODS
We retrospectively evaluated 53 patients who underwent cardiac surgery after the introduction of the P-con technique at our institute. There were 20 patients in the P-con group and 33 patients in the control group in whom concentrated platelet were not harvested.


RESULTS
The patients characteristics and preoperative cardiac and pulmonary function did not differ between the two groups. The percentages of platelets and leukocytes sequestrated were 20.2+/-5.4% and 8.5+/-3.9% of the total estimated circulating cell counts, respectively. There were no significant differences in the postoperative dose of dopamine used, cardiac index, pulmonary capillary wedge pressure or intubation period between the two groups. However, the stroke volume index (p=0.005), left ventricular stroke work index (p=0.002), and ratio of the arterial oxygen tension to the inspired fraction of oxygen on extubation (p=0.02) were significantly greater in the P-con group as compared with those in the control.


CONCLUSIONS
P-con improved cardiac and pulmonary function after CPB. Simultaneous sequestration of platelets and leukocytes by P-con during CPB may contribute to the improvement of cardiac and pulmonary function after cardiac surgery.
Kunitomo
R
R
The First Department of Surgery, Kumamoto University School of Medicine, Kumamoto, Japan. ryuji@kaiju.medic.kumamoto-u.ac.jp
Kitamura
N
N
Utoh
J
J
Nishimura
K
K
Sakaguchi
H
H
Uemura
S
S
Hagiwara
S
S
D000368:Aged; D001792:Blood Platelets / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D005260:Female; D006321:Heart / Q000502:physiology* / Q000503:physiopathology; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes / Q000502:physiology; D008168:Lung / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D010976:Platelet Count; D011184:Postoperative Period; D012189:Retrospective Studies