Effects of leukocyte-depleted reoxygenation on endothelial and ventricular function: with observation of a short time...

Postoperative myocardial global dysfunction causes mortality and morbidity in cyanotic congenital defects. This study investigates whether leukocyte depletion during coronary perfusion following reoxygenation can maintain endothelial and myocyte function, or less oxidant damage in a porcine neonatal model. After 30 minutes hypoxemia, 13 piglets underwent 60 minutes reoxygenation. The aorta was clamped and coronary reperfusion was either with normal blood (N=6), or leukocyte free blood by an inline filter (N=7). Cardiac function and endothelial response were assessed before and after cardiopulmonary bypass (CPB). Contractile recovery was improved by leukocyte depletion. Additionally, the antioxidant reserve capacity reserved more (534 36 versus 772 91; p<0.05) than reoxygenation without a leukocyte-depleting filter. Leukocyte depletion returned more extreme relaxation to acetylcholine (71.8 20.4% versus 41.2 9.8%; p<0.05), but did not change the endothelium-independent relaxation to sodium nitroprusside in either group. Activated leukocytes release oxygen free radicals that play a role in deterioration of the endothelial/myocardial function after reoxygenation and this deterioration in cyanotic heart diseases may be avoided by the use of the leukocyte-depleting filter.