Effects of a leukocyte depleting arterial line filter on perioperative morbidity in patients undergoing cardiac surgery: a controlled randomized trial.
BACKGROUND
Activated leukocytes may increase morbidity in cardiac surgery. The objective of this study is to investigate the influence on morbidity of leukocyte-depleting blood filters placed into the arterial line of cardiopulmonary bypass circuits.


METHODS
Simple, blind, prospective, randomized and controlled clinical trial carried out in a cardiac surgery ICU at a university center. We included 159 consecutive low-risk patients (ie, Parsonnet score < 10) undergoing cardiac surgery who were initially stratified in three risk levels according to the Parsonnet score at admission into the hospital (ie, low, < 4; middle, 4 to 7; and high, 8 to 10). Once stratified, all patients were randomized to undergo cardiopulmonary bypass either with a conventional blood filter or with a leukocyte filter (randomization ratio, 2:1). The outcome variable was morbidity. Patients were considered to have a high morbidity if any of the following clinical situations were present (ie, pulmonary dysfunction, cardiac dysfunction, perioperative infections, postoperative hyperthermia, and hyperdynamic states).


RESULTS
The leukocyte filter was used in 52 patients and the conventional filter in 107 patients. The morbidity rate was similar in both groups, but patients with leukocyte filter had a lower incidence of perioperative infections, fever, and hyperdynamic states as compared with patients with the conventional filter.


CONCLUSIONS
Leukocyte filtration in patients undergoing cardiac surgery with extracorporeal perfusion showed no measurable effects on postoperative morbidity. However, although not statistically significant, a decrease was observed in the rates of perioperative infection, fever, and hyperdynamic states.
Leal-Noval
Santiago R
SR
Division of Critical Care, Hospital Universitario Virgen del Rocío, Sevilla, Spain. sramon@cica.es
Amaya
Rosario
R
Herruzo
Angel
A
Hernández
Ana
A
Ordóñez
Antonio
A
Marín-Niebla
Ana
A
Camacho
Pedro
P
D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D002319:Cardiovascular System / Q000503:physiopathology; D005260:Female; D005374:Filtration / Q000295:instrumentation; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D007958:Leukocyte Count; D047589:Leukocyte Reduction Procedures / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012129:Respiratory Function Tests; D016896:Treatment Outcome