Changes in lymphocyte subpopulations as a result of cardiopulmonary bypass

DePalma, Louis; Yu, Ming; McIntosh, Charles L.; Swain, J A; Davey, Richard J.

doi:10.1016/s0022-5223(19)36758-3

Cited by 40 publications

(16 citation statements)

References 14 publications

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“…Such inertia of the immune response in re-operated patients could be explained by the fact that these patients belong to an older age [10]. These changes are independent on blood transfusions [17], and indicate the depression of the immune response [4]. However, we have not found excessive increase of the inflammatory parameters in peripheral circulation patients during re-operation, and this observation is in orchestra with findings of Klein and co-workers [18].…”

Section: Discussionsupporting

confidence: 68%

“…Open-heart surgery is associated with the inflammatory response, which occurs as a result of the contact of blood and artificial surfaces of the circuit, ischemia-reperfusion damage, surgical trauma, changes in body temperature and release of endotoxin [17,18]. The purpose of this study was to clarify whether the inflammatory markers in the blood become more intensive in patients with re-operation by using CPB, after second impact on the immune system.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting

Branislav¹,

Petar²,

Predrag³

et al. 2013

J Clin Exp Cardiolog

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Background: Determination of biomarkers can assess cardiac injury induced by cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG). Open heart surgery initiates inflammatory reaction. Aim of this study was to compare the inflammatory response in patients undergoing first-and CABG-reoperation. Methods: Fifty-four patients (16% female, 84% male; 60.5 ± 6.5 vs. 66.2 ± 7.3 years) scheduled for elective cardiac surgery were divided into: Group 1, CABG primo-operation, and Group 2, CABG re-operation (redo CABG). The extent of inflammation was estimated by measuring interleukin (IL)-6 and highly sensitive C-reactive protein (hs-CRP) in plasma. Blood samples were collected: 24 hours prior, 6, and 24 hours after initiation of CPB. Demographic data, preoperative risk assessment Euro-score, laboratory values and clinical outcomes: atrial fibrillation rate, tracheal intubation time, revisions, blood loss, length of Intensive Care Unit (ICU) and hospital stay were analyzed. Results: Baseline levels of IL-6 (p < 0.001) were significantly higher in re-operated patients. IL-6 increased significantly 6 hours after initiation of CPB in both groups (p < 0.0001). Day after surgery IL-6 (p = 0.472) and hs-CRP (p = 0.248) levels were similar in both groups. Although hs-CRP was higher in Group 1 (90.45 ± 46.67 vs. 72.91 ± 57.31 mg/L) this had no statistical significance. Clinical outcomes have been in positive correlations with inflammation, but statistically insignificant in both groups. Conclusion: Monitoring of IL-6 and hs-CRP during redo CABG has shown that CPB cause inflammatory reaction but repeated use does not cause extensive reaction potentially harmful for myocardium.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting

Branislav¹,

Petar²,

Predrag³

et al. 2013

J Clin Exp Cardiolog

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“…Few reports have studied the morbidity and mortality of cardiac surgery in HIV patients. Frater and associates8 reported four deaths among 11 HIV patients operated upon for endocarditis. These four deaths occurred in a group of seven patients all operated upon for uncontrolled infection at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Surgery in Patients with Human Immunodeficiency Virus Infection: Indications and Results

et al. 1992

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Ten patients with human immunodeficiency virus (HIV) infections underwent cardiac surgery using cardiopulmonary bypass. All were in Centers for Disease Control (CDC) group II. The cardiac involvement was either urgent or severely symptomatic in all cases. One patient died due to acquired immunodeficiency syndrome (AIDS) unrelated cause. No complications were encountered in this series. Eight of the nine survivors were available for follow-up. Three of these eight patients progressed to AIDS (CDC group IV) and subsequently died. Five patients are alive and in CDC group II. Prognosis of the HIV infection and the natural history of the cardiac disease are the two main elements to be considered whenever cardiac surgery is required.

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“…Transfusion-related graft-versus-host reaction, in which the lymphocytes in the transfused blood cause host cell destruction, occurs primarily in immunocompromised patients and has been reported in neonates and immunocompromised children [25][26][27][28]. This condition occurs primarily in premature infants or children with rapid acute blood loss, cardiopulmonary bypass, cancer, or severe systemic illness [29]. Burned children are immunosuppressed and require massive transfusions in the operating room, thus putting them at risk for this complication.…”

Section: Incompatibility/immunologic Factorsmentioning

confidence: 99%

Children are not little adults: blood transfusion in children with burn injury

Palmieri

2017

Burns &Amp; Trauma

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Blood transfusion in burns larger than 20% total body surface area (TBSA) are frequent due to operative procedures, blood sampling, and physiologic response to burn injury. Optimizing the use of blood transfusions requires an understanding of the physiology of burn injury, the risks and benefits of blood transfusion, and the indications for transfusion. Age also plays a role in determining blood transfusion requirements. Children in particular have a different physiology than adults, which needs to be considered prior to transfusing blood and blood products. This article describes the physiologic differences between children and adults in general and after burn injury and describes how these differences impact blood transfusion practices in children.

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Changes in lymphocyte subpopulations as a result of cardiopulmonary bypass

Cited by 40 publications

References 14 publications

Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting

Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting

Cardiac Surgery in Patients with Human Immunodeficiency Virus Infection: Indications and Results

Children are not little adults: blood transfusion in children with burn injury

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