Document Detail


A lipopolysaccharide adsorber in adult cardiopulmonary bypass: a single centre randomised controlled pilot trial.
MedLine Citation:
PMID:  20385666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to describe the biochemical effects and safety of selective removal of endotoxin from whole blood using a lipopolysaccharide adsorber during complex cardiac surgery. METHODS: We carried out a single centre prospective randomised controlled pilot trial in patients undergoing elective cardiac surgery using cardiopulmonary bypass (CPB) at a large UK cardiothoracic institution. Seventeen patients were randomly allocated to one of two groups: with or without an adsorber included in the CPB circuit. Fourteen patients were included in a complete case analysis. Blood samples were taken at the time of consent, immediately following anaesthesia, at 60, 180 and 360 min after the institution of CPB, and the morning following surgery. Primary outcomes were plasma levels of endotoxin, IL-6, IL-8 and TNF-alpha. Secondary outcomes were measures of patient safety including blood chemistry and coagulation parameters, length of stay, and adverse events. RESULTS: No differences were seen in endotoxin or cytokine levels between adsorber and control groups at any of the measured time-points. No difference between groups was detected in measures of patient safety following the intervention. Haemoglobin and haematocrit were significantly lower in the intervention group pre-bypass, P=0.02 in both instances. CONCLUSION: There was no effect of the adsorber on endotoxin levels or inflammatory response in this study, we have demonstrated the device to be safe in a complex cardiac surgery setting.
Authors:
Ravi J De Silva; Johanna Armstrong; Fiona Bottrill; Kimberley Goldsmith; Simon Colah; Alain Vuylsteke
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-04-12
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  11     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-21     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  86-92     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge CB23 3RE, UK.
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MeSH Terms
Descriptor/Qualifier:
Adsorption
Aged
Aged, 80 and over
Blood Coagulation
Cardiac Surgical Procedures* / adverse effects
Cardiopulmonary Bypass* / adverse effects
Endotoxins / blood
England
Equipment Design
Extracorporeal Circulation / adverse effects,  instrumentation*
Female
Humans
Inflammation / blood,  etiology,  prevention & control*
Inflammation Mediators / blood
Interleukin-6 / blood
Interleukin-8 / blood
Length of Stay
Lipopolysaccharides / blood*
Male
Middle Aged
Pilot Projects
Prospective Studies
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Tumor Necrosis Factor-alpha / blood
Chemical
Reg. No./Substance:
0/Endotoxins; 0/IL6 protein, human; 0/IL8 protein, human; 0/Inflammation Mediators; 0/Interleukin-6; 0/Interleukin-8; 0/Lipopolysaccharides; 0/Tumor Necrosis Factor-alpha

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


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