Leukocyte filtration of the cardiotomy suction. Does it affect systemic leukocyte activation or pulmonary function?
Leukocyte filtration of the cardiotomy suction. Does it affect systemic leukocyte activation or pulmonary function?
Background: Cardiopulmonary bypass is thought to propagate a global systemic response through contact with the non-physiological surfaces of the extracorporeal circuit, leading to the stimulation of leukocytes, their adherence to endothelial cells and the release of cytotoxic molecules. This, in turn, has been shown to accelerate pulmonary injury. This study tested a new leukocyte-filtration system (RemoweLL) against a conventional system with no leukocytedepleting capacity to determine the efficacy of the filtration system and its effects on pulmonary function.
Methods: Thirty patients underwent coronary artery bypass graft surgery using either the RemoweLL filtration system (15 patients) or a conventional cardiopulmonary bypass circuit (15 patients). Data were collected on the total number of leukocytes, their differentiation and activation, using the leukocyte adhesion integrin CD11b as a surrogate marker. Pulmonary function was assessed using the Alveolar-arterial Oxygenation Index (AaOI) and patients were categorized using the Berlin definition of acute respiratory distress syndrome (ARDS).
Results: Both groups showed significant increases in leukocyte numbers during CPB (p<0.001), with no differences noted between the groups. CD11b showed a significant increase in both groups, with peak activation occurring at the end of
CPB, but no difference between the groups (p=0.8). There was a trend towards lower AaOI increases in the filtration group, but this did not reach significance (p=0.075) and there was no difference in ARDS definitions (p=0.33).
Conclusions: Leukocyte filtration of cardiotomy suction did not influence total leukocyte counts or activation as measured by CD11b upregulation. Furthermore, no evidence could be found to suggest improved pulmonary function.
574-582
Issitt, Richard
e5d2a06c-e3c3-439c-ba9a-c94777f1a12b
Ball, Jon
59467a3e-0764-4735-86d6-b5dba7d023e1
Bilkhoo, Indie
d8e84794-e2e5-4e30-b476-9935b10d1d71
Mani, Adnan
28db16f0-52a9-41f6-a8f3-9c109d6d6e1a
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
October 2017
Issitt, Richard
e5d2a06c-e3c3-439c-ba9a-c94777f1a12b
Ball, Jon
59467a3e-0764-4735-86d6-b5dba7d023e1
Bilkhoo, Indie
d8e84794-e2e5-4e30-b476-9935b10d1d71
Mani, Adnan
28db16f0-52a9-41f6-a8f3-9c109d6d6e1a
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Issitt, Richard, Ball, Jon, Bilkhoo, Indie, Mani, Adnan, Walsh, Bronagh and Voegeli, David
(2017)
Leukocyte filtration of the cardiotomy suction. Does it affect systemic leukocyte activation or pulmonary function?
Perfusion, 32 (7), .
(doi:10.1177/0267659117709922).
Abstract
Background: Cardiopulmonary bypass is thought to propagate a global systemic response through contact with the non-physiological surfaces of the extracorporeal circuit, leading to the stimulation of leukocytes, their adherence to endothelial cells and the release of cytotoxic molecules. This, in turn, has been shown to accelerate pulmonary injury. This study tested a new leukocyte-filtration system (RemoweLL) against a conventional system with no leukocytedepleting capacity to determine the efficacy of the filtration system and its effects on pulmonary function.
Methods: Thirty patients underwent coronary artery bypass graft surgery using either the RemoweLL filtration system (15 patients) or a conventional cardiopulmonary bypass circuit (15 patients). Data were collected on the total number of leukocytes, their differentiation and activation, using the leukocyte adhesion integrin CD11b as a surrogate marker. Pulmonary function was assessed using the Alveolar-arterial Oxygenation Index (AaOI) and patients were categorized using the Berlin definition of acute respiratory distress syndrome (ARDS).
Results: Both groups showed significant increases in leukocyte numbers during CPB (p<0.001), with no differences noted between the groups. CD11b showed a significant increase in both groups, with peak activation occurring at the end of
CPB, but no difference between the groups (p=0.8). There was a trend towards lower AaOI increases in the filtration group, but this did not reach significance (p=0.075) and there was no difference in ARDS definitions (p=0.33).
Conclusions: Leukocyte filtration of cardiotomy suction did not influence total leukocyte counts or activation as measured by CD11b upregulation. Furthermore, no evidence could be found to suggest improved pulmonary function.
Text
Leucocyte Filtration of the Cardiotomy Suction. Does it affect Systemic Leucocyte Activation or Pulmonary Function?
- Accepted Manuscript
Text
(Abstract) Leucocyte Filtration of the Cardiotomy Suction. Does it affect Systemic Leucocyte Activation or Pulmonary Function? Title Page
- Accepted Manuscript
More information
Accepted/In Press date: 21 April 2017
e-pub ahead of print date: 23 May 2017
Published date: October 2017
Organisations:
Researcher Development, Centre for Innovation & Leadership, Advancing Clinical & Expert Practice
Identifiers
Local EPrints ID: 408128
URI: http://eprints.soton.ac.uk/id/eprint/408128
ISSN: 0267-6591
PURE UUID: 41390533-43a0-4909-9525-b096afc17c11
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Date deposited: 12 May 2017 04:04
Last modified: 16 Mar 2024 03:00
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Contributors
Author:
Richard Issitt
Author:
Jon Ball
Author:
Indie Bilkhoo
Author:
Adnan Mani
Author:
David Voegeli
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