DEPLETION OF ACTIVATED NEUTROPHILS BY A FILTER DURING CARDIAC-VALVE SURGERY

Purpose: To determine whether inclusion of a neutrophil-specific filte r into the extracorporeal circuit during open heart valve surgery alte rs postoperative outcomes. Methods: Convenience sampling of 24 patient s undergoing elective open heart valve surgery between July 1993 and J une 1994. Patients were randomized to a neutrophil-specific filter (n = 11) or to a standard blood filter (n = 13) during cardiopulmonary by pass. Results: Neutrophil-specific filter diminished (P < 0.02) the ex pression of CD18, a neutrophil surface adhesion molecule, at 1 (84.5 /- 4.2 vs 94.8 +/- 3.8%), 4 (80.0 +/- 4.2 vs 95.1 +/- 3.9%) and 24 hr (75.2 +/- 4.2 vs 98.2 +/- 3.9%) post-operatively compared with standar d filter. Total white blood cell count, neutrophil count, and proinfla mmatory cytokines (IL-6, IL-8) were similar between groups at all time s. Measured outcomes including: PaO2, cardiac index, ejection fraction , haemodynamic variables, use of inotropes, spirometry (FEV(1), FVC), and hospitalization duration were similar between groups. Conclusions: Inclusion of the neutrophil filter during open heart valve surgery se lectively depletes activated neutrophils. There were no other detectab le differences between the two groups and the use of a neutrophil-spec ific filter in routine clinical practice for patients undergoing open heart valve surgery is not supported.