Effects of Leukocyte Filtration on Blood Components and Cytokines of Residual Pump Blood after Cardiopulmonary Bypass: A Randomized Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WUBin ^1,2 , HUJin-xiao ¹ , LOUSong ¹ , LONGCun ¹ ,  WANGHui-ying ¹

1. Department of Extracorporeal Circulation, Fu Wai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, P. R. China;
2. Department of Anesthesiology, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, P. R. China;

Corresponding author：

WANGHui-ying, Email: qiqi840721@aliyun.com

Keywords：

Leukocyte filter; Cardiopulmonary bypass; Leukocyte; Cytokine; Randomized controlled trial

DOI：

10.7507/1007-4848.20140046

Video：

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Objective To evaluate the effects of leukocyte filtration (LF) on blood components and cytokines of residual pump blood after cardiopulmonary bypass (CPB). Methods Forty patients who underwent selective cardiac surgery with CPB in Fu wai Hospital from December 2012 to February 2013 were included in this study. There were 34 male and 6 female patients with their age of 16-72 years. All the patients were randomly divided into an experimental group and a control group. In the experimental group, patients received residual pump blood transfusion which had been processed with LF and stored in sterile blood collection bags. In the control group, patients received residual pump blood transfusion which was stored in sterile blood collection bags without LF process after CPB. Blood samples were taken before CPB (T1) at the end of CPB (T2) and 4 hours (T3) after CPB to examine blood components and concentrations of IL-6, IL-10 and TNF-α. Results White blood cell count and neutrophil count of the experimental group were significantly lower than those of the control group at T2 and T3 (P<0.05). There was no statistical difference in red blood cell count, hemoglobin,hematocrit or free hemoglobin at respective time points between the 2 groups (P>0.05). There was no statistical difference in plasma IL-6,IL-10 or TNF-α concentrations at different time points within either group (P>0.05) or at respective time points between the 2 groups (P>0.05). Conclusion LF can reduce white blood cell count and neutrophil count of residual pump blood,but does not significantly change other blood components and plasma concentrations of IL-6,IL-10 or TNF-α after CPB.

Citation： WUBin, HUJin-xiao, LOUSong, LONGCun, WANGHui-ying. Effects of Leukocyte Filtration on Blood Components and Cytokines of Residual Pump Blood after Cardiopulmonary Bypass: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 147-150. doi: 10.7507/1007-4848.20140046 Copy

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8.	Samankatiwat P,Samartzis I,Lertsithichai P,et al.Leucocyte depletion in cardiopulmonary bypass:a comparison of four strategies.Perfusion,2003,18 (2):95-105.
9.	Roth M,Kraus B,Scheffold T,et al.The effect of leukocyte-depleted blood cardioplegia in patients with severe left ventricular dysfunction:a randomized,double-blind study.J Thorac Cardiovasc Surg,2000,120 (4):642-650.
10.	Smit JJ,de Vries AJ,Gu YJ,et al.Filtration of activated granulocytes during cardiopulmonary bypass surgery:a morphologic and immunologic study to characterize the trapped leukocytes.J Lab Clin Med,2000,135 (3):238-246.
11.	Markus R,Frank T,Andreas M,et al.Leukocyte depletion during cardiac operation:a new approach through the venous bypass circuit.Ann Thorac Surg,1999,67 (3):604-609.
12.	Fitzgerald DJ,Cecere G.Hemofiltration and inflammatory mediators.Perfusion,2002,17 (Suppl):23-28.
13.	安珂,舒海华,黄文起.体外循环相关肺损伤的发生机制与对策[EB/OL].[2007-09-10].

1. Asimakopoulos G.The inflammatory response to CPB:the role of leukocyte filtration.Perfusion,2002,17 (Suppl):7-10.
2. Miller BE,Levy JH.The inflammation response to cardiopulmonary bypass.J Cardiothorac Vasc Anesth,1997,11 (3):355-366.
3. 谢如锋,许亚勇,徐澄清,等.白细胞过滤器及其临床应用.中国输血杂志,1995,8 (1):102-104.
4. Chen YF,Tsai WC,Lin CC,et al.Leukocyte depletion attenuates expression of neutrophil adhesion molecules during cardiopulmonary bypass in human beings.J Thorac Cardiovasc Surg,2002,123 (2):218-224.
5. Gessler P,Pfenninger J,Pfammatter JP,et al.Inflammatory response of neutrophil granulocytes and monocytes after cardiopulmonary bypass in pediatric cardiac surgery.Intensive Care Med,2002,28 (12):1786-1791.
6. Scholz M,Simon A,Matheis G,et al.Leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery.Inflamm Res,2002,51 (7):363-368.
7. Sutton SW,Pstel AN,Chase VA,et al.Clinical benefits of continuous leukocyte filtration during cardiopulmonary bypass in patients undergoing vavular repair or replacement.Perfusion,2005,20 (1):21-29.
8. Samankatiwat P,Samartzis I,Lertsithichai P,et al.Leucocyte depletion in cardiopulmonary bypass:a comparison of four strategies.Perfusion,2003,18 (2):95-105.
9. Roth M,Kraus B,Scheffold T,et al.The effect of leukocyte-depleted blood cardioplegia in patients with severe left ventricular dysfunction:a randomized,double-blind study.J Thorac Cardiovasc Surg,2000,120 (4):642-650.
10. Smit JJ,de Vries AJ,Gu YJ,et al.Filtration of activated granulocytes during cardiopulmonary bypass surgery:a morphologic and immunologic study to characterize the trapped leukocytes.J Lab Clin Med,2000,135 (3):238-246.
11. Markus R,Frank T,Andreas M,et al.Leukocyte depletion during cardiac operation:a new approach through the venous bypass circuit.Ann Thorac Surg,1999,67 (3):604-609.
12. Fitzgerald DJ,Cecere G.Hemofiltration and inflammatory mediators.Perfusion,2002,17 (Suppl):23-28.
13. 安珂,舒海华,黄文起.体外循环相关肺损伤的发生机制与对策[EB/OL].[2007-09-10].

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effects of Leukocyte Filtration on Blood Components and Cytokines of Residual Pump Blood after Cardiopulmonary Bypass: A Randomized Controlled Trial

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