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Leukocyte depletion during CPB: effects on inflammation and lung function

Célio Gomes de Amorim1, Luiz Marcelo Sá Malbouisson, Francisco Costa da Silva

  • 1Discipline of Anesthesiology-Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil, celioamorim@uol.com.br.

Inflammation
|October 5, 2013
PubMed

Insights

Leukocyte filtration during cardiopulmonary bypass (CPB) temporarily reduced neutrophil counts and improved lung function in coronary artery bypass grafting (CABG) patients. However, long-term benefits were not observed, with only transient reductions in IL-10 levels.

Area of Science:

  • Cardiovascular Surgery
  • Immunology
  • Pulmonary Medicine

Background:

  • Cardiopulmonary bypass (CPB) is associated with systemic inflammation and pulmonary dysfunction.
  • Coronary artery bypass grafting (CABG) frequently utilizes CPB, necessitating strategies to mitigate adverse effects.

Purpose of the Study:

  • To investigate the impact of leukocyte filtration during CPB on inflammatory markers and lung function post-CABG.
  • To compare outcomes between patients undergoing standard CPB versus CPB with leukocyte filtration.

Main Methods:

  • A prospective randomized study comparing CPB leukocyte filtration (n=9) against standard CPB (n=11) in CABG patients.
  • Evaluation of computed tomography, oxygenation (PaO2/FiO2), leukocyte counts, hemodynamic data, shunt fraction, interleukins (IL-10), elastase, and myeloperoxidase.
  • Statistical analysis using two-factor ANOVA for repeated measurements.

Main Results:

  • The leukocyte filtration group exhibited reduced neutrophil counts within 50 minutes of CPB.
  • A lower shunt fraction was observed up to 6 hours post-surgery in the filtered group.
  • Serum levels of IL-10 were significantly lower at the end of surgery in patients who received leukocyte filtration.

Conclusions:

  • Leukocyte depletion during CPB transiently reduces neutrophil sequestration and IL-10 levels.
  • CPB leukocyte filtration offers only temporary improvements in lung function post-CABG.
  • Further research may be needed to optimize filtration strategies for sustained benefits.

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