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Higher bypass temperature correlates with increased white cell activation in the cerebral microcirculation
Vesa Anttila1, Ikuo Hagino, David Zurakowski
1Department of Cardiovascular Surgery, Children's Hospital Boston, Harvard Medical School, Boston, Mass, USA.
The Journal of Thoracic and Cardiovascular Surgery
|June 3, 2004
Summary
Higher cardiopulmonary bypass temperatures and lower flow rates increase leukocyte activation in the brain's microcirculation. This suggests temperature and flow rate significantly influence the inflammatory response during bypass surgery.
Area of Science:
- Cardiovascular Surgery
- Neuroscience
- Inflammation Research
Background:
- Cardiopulmonary bypass (CPB) triggers a systemic inflammatory response.
- This response involves leukocyte and endothelial cell activation, particularly in the cerebral microcirculation.
Purpose of the Study:
- To investigate the impact of CPB temperature and flow rate on leukocyte and endothelial cell adhesion.
- To assess the influence of these variables on cerebral microcirculation inflammation.
Main Methods:
- Intravital microscopy was used to examine the cerebral microcirculation in 36 piglets.
- Animals underwent CPB at varying temperatures (15°C, 25°C, 34°C) and flow rates (10-50 mL.kg⁻¹.min⁻¹).
- Leukocyte adhesion and rolling were quantified using Rhodamine staining.
Main Results:
- Increased bypass temperature significantly correlated with higher leukocyte adhesion and rolling.
- Lower flow rates during CPB were associated with more adherent leukocytes.
- Higher temperatures (34°C) and lower flow rates (10 mL.kg⁻¹.min⁻¹) led to increased neurologic damage.
Conclusions:
- Leukocyte activation in the cerebral microcirculation is exacerbated by higher CPB temperatures and lower flow rates.
- These findings highlight temperature and flow rate as critical modulators of the inflammatory response during CPB.