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Related Experiment Videos

Reduction of complement activation during bypass by prime manipulation.

R S Bonser1, J R Dave, E T Davies

  • 1Department of Surgery, Brompton Hospital, London, England.

The Annals of Thoracic Surgery
|February 1, 1990
PubMed
Summary

Priming cardiopulmonary bypass circuits with polygeline, a plasma expander, significantly reduced complement activation compared to crystalloid or crystalloid-albumin solutions. This finding suggests polygeline may lower patient morbidity after surgery.

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Area of Science:

  • Immunology
  • Cardiovascular Surgery
  • Biochemistry

Background:

  • Complement activation is implicated in complications following cardiopulmonary bypass (CPB).
  • The choice of priming solution for extracorporeal circuits may influence complement activation.
  • Understanding these effects is crucial for mitigating CPB-associated morbidity.

Purpose of the Study:

  • To evaluate the impact of different CPB priming solutions on complement activation.
  • Specifically, to compare crystalloid alone, crystalloid with albumin, and crystalloid with polygeline.

Main Methods:

  • 36 patients undergoing coronary artery operations with CPB were studied.
  • Extracorporeal circuits were primed with crystalloid, crystalloid-albumin, or crystalloid-polygeline.

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  • Complement activation was assessed by measuring Factor B, Ba fragment, C3, and C3d levels before, during, and after CPB.

    • Main Results:

    • Complement activation occurred in all groups.
    • No significant difference in activation was observed between crystalloid and crystalloid-albumin groups.
    • The polygeline group showed persistently lower Ba fragment concentrations and a trend towards lower C3d levels, indicating reduced complement activation.

    Conclusions:

    • Addition of polygeline to the CPB priming solution effectively reduces complement activation.
    • This reduction in complement activation may translate to decreased patient morbidity post-CPB.
    • Polygeline offers a potentially inexpensive strategy to improve outcomes after cardiopulmonary bypass.