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[Study of some immune functions in cardiac patients undergoing an extra-corporeal circulation operation (author's
Insights
Cardiac surgery using extra-corporeal circulation significantly reduces globulin levels, including complement and immunoglobulins, due to consumption. These levels rebound by day 15, with no change in white blood cell activity.
Area of Science:
- Immunology
- Cardiovascular Surgery
Context:
- Patients undergoing cardiac surgery with extra-corporeal circulation (ECC) exhibit altered immune markers.
- Understanding these immune changes is crucial for managing post-operative complications.
Purpose:
- To investigate the impact of ECC on plasmatic levels of complement, immunoglobulins, and polymorphonuclear leucocyte activity in cardiac surgery patients.
- To determine the cause of observed humoral abnormalities and their implications for infectious prophylaxis.
Summary:
- Extra-corporeal circulation in cardiac surgery leads to a significant, transient decrease in total complement, complement fractions (C4, C3 activator, C3), and immunoglobulins (IgG, IgA, IgM).
- This reduction is attributed to consumption within the ECC machine and tissues, not hemodilution.
- Polymorphonuclear leucocyte activity remains unchanged, despite significant individual variations.
- Humoral abnormalities normalize by the 15th post-operative day.
Impact:
- The study highlights the transient immune suppression following ECC, emphasizing the need for careful infectious prophylaxis in cardiac surgery.
- Findings contribute to understanding the immunological consequences of cardiopulmonary bypass.
Abstract:
61 adult patients (36 men, 25 women), with coronary or valvular diseases, operated with extra-corporeal circulation, by the same surgical team, have been investigated for the plasmatic levels of total complement, fractions C4, C3 activator, C3, immunoglobulins G, A and M, for the phagocytic and bactericidal activity of polymorphonuclear leucocytes. 50 healthy adults (26 men, 24 women) have been tested as controls. Results have been statistically analyzed. Two experiments have also been performed: extra-corporeal circulation machine has run alone without a patient, and the examinations of blood samples in the machine have been performed before and at the end of the running time. Just at the end of extra-corporeal circulation, a deep and significant falling of globulins (complement and its fractions, immunoglobulins) is observed, which lasts during two days; at the 8th and 15th days after the operation, a significant and important raising of these globulins is noted. It has been demonstrated that the initial falling is not correlated with the hemodilution, but is relevant to a consumption in the machine and in the tissues. Any significant variation in polymorphonuclear leucocytes activity has not been noted, but there are strong individual variations. Importance of humoral abnormalities observed is discussed, regarding to the infectious prophylaxis in cardiac surgery.