Leucodepletion during cardiopulmonary bypass reduces blood transfusion andcrystalloid requirements

Cardiopulmonary bypass (CPB) is associated with the production of inflammat ory responses, which can have significant influence on prognosis. We studie d the effects of leucocyte-depletion filters on inflammatory parameters and early postoperative prognosis during coronary revascularization. Twenty pa tients undergoing elective coronary revascularization were randomly divided into two groups. Ten patients had leucocyte-depletion filters added to the CPB circuit (treatment group) and 10 were used as control cases (control g roup). Expression of CD11b on neutrophils, and production of myeloperoxidas e and lactoferrin, were measured in arterial samples between induction and 3 h postbypass. In addition, clinical parameters were measured during inpat ient recovery. CD11b neutrophil expression, and myeloperoxidase and lactofe rrin production, were found to be upregulated during CPB and then to declin e to preoperative levels by the third postoperative hour. Blood transfusion requirements were reduced in the treatment group, equalling 1.5 +/- 1.2 un its, compared to 2.7 +/- 1.1 units for the control group (p value = 0.034) and so were the volumes of crystalloid infused during the first 24 h postop eratively, equalling 3.9 +/- 1.2 l in the treatment group and 3.3 +/- 0.7 l in the control group (p value = 0.021). Overall, the application of leucoc yte depletion produced an early clinical advantage, underlining the need fo r an improved understanding and manipulation of the inflammatory response t o CPB.