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Published on: March 22, 2022
Clinical evaluation of the leukogard-6 arterial line filter
1Departments of Cardiac Anaesthesiology and Cardiac Surgery, Escorts Heart Institute and Reasearch Centre, Okhla Road, New Delhi, India.
Insights
The Pall leukogard-6 filter did not show significant leucocyte depleting effects during coronary artery bypass grafting. This cardiopulmonary bypass filter offers no clear clinical advantage in patients with normal heart function.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Hematology
Background:
- Leukocyte depletion filters are used during cardiopulmonary bypass to mitigate inflammatory responses.
- The Pall leukogard-6 is an arterial line filter designed for leukocyte removal.
Purpose of the Study:
- To evaluate the leukocyte depleting efficacy of the Pall leukogard-6 filter.
- To compare the leukogard-6 filter with a standard arterial line filter (Intersept Medtronic 40 micro) in patients undergoing coronary artery bypass grafting.
Main Methods:
- Prospective study involving 30 patients with normal left ventricular function undergoing elective coronary artery bypass grafting with the leukogard-6 filter.
- A control group of 29 similar patients used the Intersept Medtronic 40 micro filter.
- Blood samples analyzed for leukocyte and platelet counts, blood gas, superoxide dismutase (SOD) levels, and renal function.
- Clinical outcomes including ventilation time, ICU stay, and infection incidence were recorded.
Main Results:
- No significant differences were observed between groups in total leukocyte count, differential counts, platelet counts, blood gas parameters, pulmonary vascular resistance, ventilation time, or infection rates.
- A significant decrease in superoxide dismutase levels was noted post-bypass in the control group (p<0.01), indicating increased free radical activity.
- The leukogard-6 group showed no significant change in superoxide dismutase levels (p>0.05), suggesting reduced free radical activity, but this did not correlate with clinical parameters.
Conclusions:
- The Pall leukogard-6 arterial line filter did not demonstrate significant leukocyte depleting characteristics in this study.
- The filter did not provide a demonstrable clinical advantage in patients undergoing coronary artery bypass grafting with normal ejection fraction.
- Further research may be needed to explore potential benefits in different patient populations or under varied clinical conditions.
Abstract:
To assess the leucocyte depleting characteristics of the Pall leukogard-6 arterial line leucocyte depleting filter, it was incorporated in the extracorporeal circuit of 30 patients with normal left ventricular function scheduled for elective coronary artery bypass grafting. The Intersept Medtronic 40 micro arterial line filter which is normally used at our centre was used in 29 similar patients. Blood samples were drawn for estimation of total and differential leucocyte and platelet counts, blood gas analysis, superoxide dismutase levels and renal function tests at various time points. Ventilation time, length of ICU stay and incidence of infection were recorded. No significant difference was observed between the two groups regarding total leucocyte count, percentage of neutrophils and lymphocytes, platelet count, arterial oxygen and carbon dioxide tensions, pulmonary vascular resistance, ventilation time and postoperative infection. A significant difference was observed between the prebypass levels of superoxide dismutase 89.63 +/- 49.69 SOD units/ml, and 24 hours post bypass levels 66.62 +/- 36.23 SOD units/ml, (p<0.01), in the control group. In the leukogard filter group, the difference between pre bypass levels of superoxide dismutase 82.47 +/- 50.58 SOD units/ml and 24 hours post bypass 73.44 +/- 41.10 SOD units/ml, (p>0.05), was not significant. This indicated less free radical activity in the leukogard filter group, but this beneficial effect of the leukogard-6 filter did not correlate with any clinical parameter. In this study, the leukoard-6 filter did not exhibit leucocyte depleting characteristics following cardiopulmonary bypass and is unlikely to be of significant advantage when incorporated in the extracorporeal circuit for coronary artery bypass grafting, in patients with normal ejection fraction.
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