A. Sahlman et al., No impact of a leucocyte depleting arterial line filter on patient recovery after cardiopulmonary bypass, ACT ANAE SC, 45(5), 2001, pp. 558-563
Citations number
17
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Backround: Contact of blood with foreign surfaces in the cardiopulmonary by
pass (CPB) circuit induces an inflammatory response and immunosuppression w
hich are associated with several organ dysfunctions following cardiac surge
ry. The aim of the present study was to evaluate clinical patient recovery
after coronary artery bypass surgery (CABG) using CPB with leucocyte filtra
tion or no arterial line filter.
Methods: Sixty patients scheduled for CABG were randomly assigned to underg
o CPB with a leucocyte depleting arterial line filter (Pall LG6 (R)) or no
filter. Total leucocyte count and platelet count were determined before and
after CPB. Values for blood urea nitrogen, serum creatine, serum sodium an
d potassium, serum osmolality, urine creatine, urine sodium and potassium,
and urine osmolality were recorded at baseline, at 6 h and 24 h after CPB,
and on the 5th postoperative day. Complement status was evaluated by measur
ing the levels of C3 and C4 before surgery and 24 h after CPB. Need for pos
toperative inotropic support was recorded, as was oxygen index prior to and
after tracheal extubation. Times to awakening and tracheal extubation were
noted, as were length of stay at the intensive care unit (ICU) and the hos
pital. Amount of chest drainage until 24 h and need for red blood cell tran
sfusions were recorded.
Results: The level of C3 at 24 h was significantly lower in LG6 (R) -patien
ts, but no further differences were detected between the groups in any of t
he laboratory or clinical parameters except for greater chest drainage in L
G6 (R) -patients. However, need for red blood cell transfusions was similar
in both groups.
Conclusion: Leucocyte filtration in our elective CABG patients did not have
any impact on pulmonary gas exchange, need for postoperative inotropic sup
port, length of postoperative mechanical ventilation, or length of ICU or h
ospital stay.