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Updated: Jul 11, 2026
A Recovery Cardiopulmonary Bypass Model Without Transfusion or Inotropic Agents in Rats
Published on: March 23, 2018
Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass
Ulf Abdel-Rahman1, Stefan Margraf, Tayfun Aybek
1Department of Traumatology and Hand Surgery, Heinrich-Heine University, Düsseldorf, Germany. martin.scholz@uni-duesseldorf.de.
Insights
The leukocyte inhibition module (LIM) improves cardiac function after cardiopulmonary bypass (CPB) by reducing neutrophil activity and enhancing spleen sequestration. This cardiac surgery innovation offers better perioperative hemodynamics and recovery.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Medical Devices
Background:
- Cardiopulmonary bypass (CPB) can lead to excessive leukocyte activity, potentially impairing cardiac function.
- The leukocyte inhibition module (LIM) is an arterial in-line device designed to mitigate this overactivation during cardiac surgery.
Purpose of the Study:
- To investigate the effects of LIM on cardiac function in a porcine model following CPB.
- To assess whether LIM can limit neutrophil activation and improve hemodynamic parameters post-CPB.
Main Methods:
- A porcine model underwent 60 minutes of myocardial ischemia and 30 minutes of reperfusion during CPB, with or without LIM.
- Cardiac indices (CI) and function were measured pre- and post-CPB using a Swan-Ganz catheter.
- Neutrophil activation and organ infiltration were evaluated using technetium labeling, scintigraphy, and histology.
Main Results:
- LIM significantly prevented the increase in peripheral neutrophil counts associated with CPB.
- The cardiac index (CI) declined significantly in the control group but remained stable in the LIM group post-CPB.
- The LIM group exhibited higher CI and end-systolic pressure-volume relationship (ESPVR) values, with lower systemic and pulmonary vascular resistance.
Conclusions:
- LIM effectively improves perioperative hemodynamics and cardiac function after CPB.
- The benefits of LIM are attributed to its ability to limit neutrophil activity and promote neutrophil sequestration in the spleen.
Background:
The arterial in line application of the leukocyte inhibition module (LIM) in the cardiopulmonary bypass (CPB) limits overshooting leukocyte activity during cardiac surgery. We studied in a porcine model whether LIM may have beneficial effects on cardiac function after CPB.
Methods:
German landrace pigs underwent CPB (60 min myocardial ischemia; 30 min reperfusion) without (group I; n = 6) or with LIM (group II; n = 6). The cardiac indices (CI) and cardiac function were analyzed pre and post CPB with a Swan-Ganz catheter and the cardiac function analyzer. Neutrophil labeling with technetium, scintigraphy, and histological analyses were done to track activated neutrophils within the organs.
Results:
LIM prevented CPB-associated increase of neutrophil counts in peripheral blood. In group I, the CI significantly declined post CPB (post: 3.26 +/- 0.31; pre: 4.05 +/- 0.45 l/min/m2; p < 0.01). In group II, the CI was only slightly reduced (post: 3.86 +/- 0.49; pre 4.21 +/- 1.32 l/min/m2; p = 0.23). Post CPB, the intergroup difference showed significantly higher CI values in the LIM group (p < 0.05) which was in conjunction with higher pre-load independent endsystolic pressure volume relationship (ESPVR) values (group I: 1.57 +/- 0.18; group II: 1.93 +/- 0.16; p < 0.001). Moreover, the systemic vascular resistance and pulmonary vascular resistance were lower in the LIM group. LIM appeared to accelerate the sequestration of hyperactivated neutrophils in the spleen and to reduce neutrophil infiltration of heart and lung.
Conclusion:
Our data provides strong evidence that LIM improves perioperative hemodynamics and cardiac function after CPB by limiting neutrophil activity and inducing accelerated sequestration of neutrophils in the spleen.
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