Document Detail

The influence of leukocyte filtration during cardiopulmonary bypass on postoperative lung function. A clinical study.
MedLine Citation:
PMID:  7776678     Owner:  NLM     Status:  MEDLINE    
The accumulation of activated leukocytes in the pulmonary circulation plays an important role in the pathogenesis of lung dysfunction associated with cardiopulmonary bypass. Animal studies have demonstrated that the elimination of leukocytes from the circulation reduces postoperative lung injury and improves postoperative pulmonary function. We conducted a prospective randomized clinical study to evaluate whether postoperative lung function could be improved by use of a leukocyte filter during cardiopulmonary bypass. Elective coronary artery bypass grafting was done with a leukocyte-depleting arterial blood filter incorporated in the extracorporeal circuit (14 patients, leukocyte filter group) or without the filter (18 patients, control group). Blood samples collected at intervals before, during, and after operation were used for analysis of blood cell counts, elastase concentrations, and arterial blood gases. The use of the leukocyte filter caused no significant reduction in leukocyte count (p = 0.86). There were no differences in postoperative lung function between the groups, as assessed through (1) oxygenation index (290 for leukocyte filter group compared with 329 for control group, 95% confidence interval, 286 to 372, p = 0.21), (2) pulmonary vascular resistance (p = 0.10), and (3) intubation time (16.6 hours for leukocyte filter group versus 15.7 hours for control group, 95% confidence interval, 12.1 to 19.1 hours, p = 0.72). The levels of neutrophil elastase were significantly higher at the end of cardiopulmonary bypass in the leukocyte filter group (460 microgram/L in leukocyte filter group versus 230 microgram/L in control group, 95% confidence interval, 101 to 359 microgram/L, p = 0.003). We conclude that the clinical use of the present form of leukocyte-depleting filter did not improve any of the postoperative lung function parameters analyzed in this study.
T Mihaljevic; M Tönz; L K von Segesser; M Pasic; P Grob; J Fehr; B Seifert; M Turina
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  109     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-07-07     Completed Date:  1995-07-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1138-45     Citation Subset:  AIM; IM    
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.
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MeSH Terms
Cardiopulmonary Bypass / instrumentation,  methods*
Cell Separation
Coronary Artery Bypass / methods*
Filtration / instrumentation
Leukocyte Count
Leukocyte Elastase
Lung Diseases / prevention & control*
Middle Aged
Pancreatic Elastase / blood
Postoperative Complications / prevention & control*
Time Factors
Vascular Resistance / physiology
Reg. No./Substance:
EC Elastase; EC Elastase

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

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