Document Detail


What is the role of leukocyte depletion in cardiac surgery?
MedLine Citation:
PMID:  17360235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Leukocytes play an important pathogenic role in ischaemia-reperfusion injury. During cardiopulmonary bypass, leukocyte filters have the potential to remove leukocytes, thereby reducing contact of activated leukocytes with the endothelium of target organs. Improvement in the safety and efficacy of commercially available leukocyte filters in recent years has led to their increasing use in cardiac surgery. However, the benefits have been inconsistent. Current evidence suggests that leukocyte depletion may not have a significant impact in low risk elective coronary artery bypass grafting but may be beneficial in valve surgery and high-risk cardiac surgery. High-risk surgical groups that may benefit from leukocyte filtration are those with left ventricular hypertrophy (LV mass>300 g), poor ejection fraction (EF<40%), chronic obstructive airways disease (predicted FEV1<75%), prolonged ischaemia (cross clamp time>120 min or cardiac transplantation), paediatric cardiac surgery and patients in cardiogenic shock requiring emergency coronary artery bypass grafting. Future trials should be powered to detect important clinical end points and be designed to avoid premature exhaustion of the filter.
Authors:
Hou-Kiat Lim; James Anderson; Jee-Yoong Leong; Salvatore Pepe; Robert F Salamonsen; Franklin L Rosenfeldt
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-03-13
Journal Detail:
Title:  Heart, lung & circulation     Volume:  16     ISSN:  1443-9506     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-09     Completed Date:  2007-10-09     Revised Date:  2008-01-31    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  243-53     Citation Subset:  IM    
Affiliation:
Cardiac Surgical Research Unit, Alfred Hospital, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures*
Cardiopulmonary Bypass
Combined Modality Therapy
Cost-Benefit Analysis
Endothelium, Vascular / cytology
Heart Diseases / physiopathology,  surgery
Humans
Leukocyte Reduction Procedures* / economics,  methods
Myocardial Reperfusion Injury / physiopathology,  prevention & control
Risk Factors
Comments/Corrections
Comment In:
Heart Lung Circ. 2007 Oct;16(5):398-9; author reply 399-400   [PMID:  17660043 ]

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


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