Leucocyte filtration of residual heart-lung machine blood in children undergoing congenital heart surgery.
Cardiopulmonary bypass (CPB) leads to a generalized inflammatory reaction, resulting in increased postoperative leucocyte counts and decreased pulmonary function. In adults, removal of leucocytes from the residual heart-lung machine blood after CPB improved postoperative oxygenation. In children, however, the clinical effects of leucocyte filtration of the residual heart-lung machine blood are unknown. Therefore, we measured postoperative leucocyte counts and arterial blood oxygenation in children undergoing congenital cardiac surgery in a randomized prospective study. Anaesthesia and CPB were standardized. After CPB, the residual heart-lung machine blood was collected as usual. In a group of 25 children, this blood was filtered with a leucocyte depletion filter before transfusion. A control group of 25 children received this blood unfiltered. We found that the postoperative leucocyte counts were significantly lower in the filter group than in the control group (p = 0.02, repeated measurements ANOVA). This difference reached a maximum on the second postoperative day (12.9 x 10(9)/L filter versus 15.9 x 10(9)/L control, p = 0.02, Student's t-test). Values for the arterial blood oxygenation on the first postoperative day were not different between the two groups (15.5 +/- 1 kPa filter versus 14.6 +/- 1.3 kPa control, p = 0.57, Student's t-test). We conclude that leucocyte filtration of the residual heart-lung machine blood reduced systemic leucocyte counts, but did not improve arterial blood oxygenation in children after congenital heart surgery.
de Vries
A J
AJ
Department of Anaesthesiology, University Hospital Groningen, Groningen, The Netherlands. a.j.de.vries.@anest.azg.nl
Gu
Y J
YJ
van Oeveren
W
W
D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006355:Heart-Lung Machine; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D047589:Leukocyte Reduction Procedures; D008297:Male; D010101:Oxygen Consumption