title: Efficacy of the RemoweLL cardiotomy reservoir for fat and leucocyte removal from shed mediastinal blood: a randomized controlled trial.
abstract: BACKGROUND
  Re-transfusion of lipid particles and activated leucocytes with shed mediastinal blood (SMB) can aggravate cardiopulmonary bypass-associated inflammation and increase the embolic load. This study evaluated the fat and leucocyte removal capacity of the RemoweLL cardiotomy reservoir.
  
  
  METHODS
  Forty-five patients undergoing elective on-pump cardiac surgery were randomly allocated to filtration of SMB using the RemoweLL or the Admiral cardiotomy reservoir. The primary outcome was a drop in leucocytes and lipid particles obtained with the two filters. The effect of the filters on other blood cells and inflammatory mediators, such as myeloperoxidase (MPO), was also assessed.
  
  
  RESULTS
  The RemoweLL cardiotomy filter removed 16.5% of the leucocytes (p<0.001) while no significant removal of leucocytes was observed with the Admiral (p=0.48). The percentage reductions in lipid particles were similar in the two groups (26% vs 23%, p=0.2). Both filters similarly affected the level of MPO (p=0.71).
  
  
  CONCLUSIONS
  The RemoweLL filter more effectively removed leucocytes from SMB than the Admiral. It offered no advantage in terms of lipid particle clearance.
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium mglagny@chu.ulg.ac.be.
authors.forename: Marc-Gilbert
authors.initials: MG
authors.lastname: Lagny
authors.affiliation: Haematology Department, University of Liège Hospital, Liège, Belgium.
authors.forename: Andre
authors.initials: A
authors.lastname: Gothot
authors.affiliation: Division of Anaesthesiology, University of Liège Hospital, Liege Belgium.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hans
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Koch
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Francine
authors.initials: F
authors.lastname: Blaffart
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Hella
authors.affiliation: Biostatistics, Public Health Department, University of Liège, Liège, Belgium.
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Donneau
authors.affiliation: Division of Anaesthesiology, University of Liège Hospital, Liege Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Roediger
authors.affiliation: Haematology Department, University of Liège Hospital, Liège, Belgium.
authors.forename: Christelle
authors.initials: C
authors.lastname: Lecut
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Joël
authors.initials: J
authors.lastname: Pincemaïl
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cheramy-Bien
authors.affiliation: Division of Cardio-vascular and Thoracic Surgery, University of Liège Hospital, Liège, Belgium.
authors.forename: Jean-Olivier
authors.initials: JO
authors.lastname: Defraigne
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005260:Female; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D047589:Leukocyte Reduction Procedures / Q000295:instrumentation*; D007962:Leukocytes / Q000166:cytology; D008055:Lipids / Q000097:blood* / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood / Q000302:isolation & purification
chemical_list: D008055:Lipids; D009195:Peroxidase
keywords: cardiopulmonary bypass; cardiotomy reservoir; filtration; leucocyte removal; lipids