Document Detail


Cell saver for on-pump coronary operations reduces systemic inflammatory markers: a randomized trial.
MedLine Citation:
PMID:  20417770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study investigated whether intraoperative use of a cell saver reduces the systemic inflammatory response after coronary operations using cardiopulmonary bypass (CPB). METHODS: The study randomized 29 patients, 15 to cell saving of pericardial suction blood and residual blood in the CPB circuit after perfusion (cell saver group) vs 14 who received direct retransfusion of the suction blood and the CPB circuit blood (control group). Outcome measures were plasma concentrations of the inflammatory markers interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha, soluble tumor necrosis factor receptors I and II, and procalcitonin at 6, 24, and 72 hours postoperatively. RESULTS: At 6 hours postoperatively, the cell saver group displayed significantly reduced plasma levels of IL-6 and IL-8 (p < 0.05). A reduction in IL-10 was also found (p = 0.05), along with nonsignificant reductions in the remaining markers. At 24 and 72 hours, significant differences between groups no longer existed. In the cell saver group, the suction blood and CPB circuit blood were cleared for tumor necrosis factor receptors (p < 0.005), and IL-6, IL-8, IL-10, and procalcitonin were significantly reduced (p < 0.05). Median intraoperative blood loss was 250 mL in the cell saver group vs 475 mL (p < 0.02). Immediately postoperatively the hemoglobin level was higher in the cell saver group (p < 0.03). Transfusion requirements were similar. CONCLUSIONS: The cell saver reduced the systemic levels of the proinflammatory markers IL-6 and IL-8 at 6 hours after CPB. The role of the anti-inflammatory molecules IL-10 and soluble tumor necrosis factor receptors is undefined in this setting.
Authors:
Sune Damgaard; Claus H Nielsen; Lars W Andersen; Klaus Bendtzen; Michael Tvede; Daniel A Steinbr?chel
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1511-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. sunedamgaard@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Transfusion, Autologous / methods*
Calcitonin / blood
Cardiopulmonary Bypass / methods*
Coronary Artery Bypass / methods*
Coronary Disease / mortality,  surgery
Female
Follow-Up Studies
Humans
Inflammation Mediators / blood*
Interleukins / blood*
Intraoperative Care / methods
Male
Middle Aged
Postoperative Complications / blood,  mortality
Probability
Prospective Studies
Protein Precursors / blood
Reference Values
Risk Assessment
Statistics, Nonparametric
Survival Analysis
Survival Rate
Treatment Outcome
Tumor Necrosis Factor-alpha / blood
Chemical
Reg. No./Substance:
0/Inflammation Mediators; 0/Interleukins; 0/Protein Precursors; 0/Tumor Necrosis Factor-alpha; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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