Depletion of Neutrophils by Filter During Aortocoronary Bypass Surgery Transiently Improves Postoperative Cardiorespiratory Status
- From the Departments of Anesthesia and Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- From the Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- From the Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- From the Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Abstract
Study objective: To determine whether inclusion of a leukocyte specific filter into the extracorporeal circuit during aortocoronary bypass surgery alters postoperative cardiopulmonary function.
Design: Randomized, double-blinded control trial.
Setting: Tertiary care hospital.
Patients: Convenience sampling of patients undergoing elective aortocoronary bypass between October 1992 and June 1993.
Interventions: A total of 32 patients were randomized to a leukocyte specific filter (n=16) or to a standard blood filter (n=16) during the surgical procedure.
Measurements and results: White blood cell count in the standard filter group (12.2±3.6 109/L) was higher (p=0.047) than in the leukocyte filter group (9.9±2.6 109/L) at 4 h postoperatively but counts were similar (p=0.063) at 24 h (10.8±2.7 vs 8.9±2.6 109/L, respectively). Leukocyte activation assessed by chemiluminescence was similar between groups at all measurement periods. We noted transient improvements (p<0.05) in intrapulmonary shunt (19±50% vs 24±9%) and mean blood pressure (85±8 vs 76±9 mm Hg, respectively) in the leukocyte filter group compared with the standard filter group, respectively. Otherwise there were no differences noted between groups.
Conclusions: Inclusion of a leukocyte filter during cardiopulmonary bypass caused transient cardiorespiratory improvement that was lost within 24 h and did not offer any significant clinical benefits.
Footnotes
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- Accepted August 30, 2007.
- Received June 1, 1994.
- 1995 by the American College of Chest Physicians
