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.