IN-LINE LEUKOCYTE FILTRATION DURING BYPASS - CLINICAL-RESULTS FROM A RANDOMIZED PROSPECTIVE TRIAL

Leukocyte mediated pulmonary injury may delay recovery after cardiac s urgery, and leukocyte depletion during bypass has been suggested. Two groups of patients were randomly, prospectively assigned from 50 seque ntial patients to undergo open heart surgery using cardiopulmonary byp ass, either with (n = 25) or without (n = 25) leukocyte filters. The t wo groups were not significantly different regarding age, gender, race , pre-operative ejection fraction, pump time, or cross-clamp time. Pos t operative arterial blood gases (pO(2): 173 +/- 66 vs 192 +/- 107; pC O(2): 30.2 +/- 8.2 vs 30.8 +/- 8.0), pulmonary vascular resistance (PV R 105 +/- 45 vs 112 +/- 50 dyne cm(-5)), time on ventilator (17.8 +/- 6.4 vs 19.7 +/- 8.6 hr), and length of hospital stay (7.65 +/- 4.57 vs 8.52 +/- 5.87 days) were not different between groups (mean +/- SD, w ith vs without filters, respectively). Arterial oxygenation was somewh at poorer, and PVR was somewhat lower in the leukocyte filtered group. However, these trends did not produce significant decreases in total ventilator time or length of hospital stay. In-line filtration did rem ove leukocytes, but did not reduce circulating leukocyte count. In eff ect, leukocyte filtration produced an effective leukocyte concentratio n at the filter site. These data do not support routine incorporation on in-line leukocyte filtration during bypass.