Leucocyte depleting filters and cardiothoracic surgery

Hart, Susan J.; Roe, John

doi:10.1177/026765919300800606

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Experimental as well as clinical data indicate that oxygen free radicals are generated during ECC and may be a major factor contributing to postbypass organ dysfunction (1-3). One mechanism by which oxygen free radicals cause tissue damage is peroxidation of lipid membranes (3,12). In our patients we could not demonstrate oxygen free radical initiated lipid peroxidation during or after ECC, neither in LG-6 group patients nor in control patients.…”

Section: Discussioncontrasting

confidence: 76%

“…However, most of the leucocyte-mediated tissue injury will occur during reperfusion of the heart and the lungs after aortic declamping. Therefore, leucocyte depleting arterial line filters are probably more effective when included into the extracorporeal system with aortic declamping (3,4). This is supported by the fact that evaluation of the leucocyte depleting arterial line filter during in vitro perfusion demonstrated the highest leucocyte removal rate during the first 15 min of extracorporeal perfusion and a filter saturation after 60 min of in vitro perfusion (6,7).…”

Section: Discussionmentioning

confidence: 96%

“…Through these toxic compounds, leucocytes significantly contribute to the tissue injury and organ dysfunction associated with cardiopulmonary bypass (4,5). Reducing the number of circulating leucocytes during ECC should theoretically reduce the release of proteolytic enzymes and oxygen free radicals, and thereby improve pulmonary and myocardial function after cardiopulmonary bypass (3,4). trations were significantly (PAE0.03) higher during and immediately after extracorporeal circulation in LG-6 group patients.…”

mentioning

confidence: 96%

“…T HE RELEASE of proteolytic enzymes and oxygen free radicals from activated leucocytes has been repeatedly demonstrated during and after extracorporeal circulation (ECC) (1)(2)(3). Through these toxic compounds, leucocytes significantly contribute to the tissue injury and organ dysfunction associated with cardiopulmonary bypass (4,5).…”

mentioning

confidence: 99%

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Effects of a leucocyte depleting arterial line filter on perioperative proteolytic enzyme and oxygen free radical release in patients undergoing aortocoronary bypass surgery

Mair¹,

Hoermann²,

Mair

et al. 1999

Acta Anaesthesiol Scand

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The use of a leucocyte depleting arterial line filter is associated with an increased release of the proteolytic enzyme elastase, but does not reliably and consistently achieve effective leucocyte depletion during clinical perfusion. In contrast to previous studies, we could not demonstrate any significant difference in postbypass pulmonary or myocardial function between patients perfused with the leucocyte-specific arterial line filter and control patients. Our data do not support the routine use of a leucocyte depleting arterial line filter during clinical perfusion in patients undergoing elective aortocoronary bypass surgery.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 96%

mentioning

confidence: 99%

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Effects of a leucocyte depleting arterial line filter on perioperative proteolytic enzyme and oxygen free radical release in patients undergoing aortocoronary bypass surgery

Mair¹,

Hoermann²,

Mair

et al. 1999

Acta Anaesthesiol Scand

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“…Much of the earlier work was carried out on animals. 4 Latterly, a specific leucocyte-depleting arterial line filter (Pall LeukoGuard 6, LG-6) has been extensively studied in vitro and in vivo. [5][6][7] It is apparent that the activated neutrophils (especially) are being 'selectively' removed in this situation.…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of the new Pall leucocyte-depleting blood cardioplegia filter (BC1)

et al. 1998

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It is now widely acknowledged that autologous leucocytes are inappropriately activated during cardiopulmonary bypass (CPB). Removal of these activated leucocytes has been proposed as a clinical intervention. Several papers have recently reported benefits of systemic leucocyte depletion during CPB. There is also evidence that leucocyte-depleted blood cardioplegia is advantageous in the globally ischaemic human heart transplant setting. Recently, a new leucocyte-depleting filter for blood cardioplegia has been developed (Pall, BC1). In this paper, we report on the safety and efficiency of this device in the clinical situation. Fourteen patients undergoing routine cardiac surgery were recruited into this study. The BC1 blood cardioplegia filter was found to be an efficient leucocyte-depleting device, removing in excess of 70% (p = 0.001) of white blood cells, on average, from up to 5.3 litres of blood cardioplegia. The filter removed a small proportion of platelets (typically 11.3%), however, this was not statistically significant and no bleeding problems were encountered. Red cell removal was negligible and was not statistically significant, and no evidence of haemolysis was noted. The filter offered a very low resistance to flow with a mean pressure drop (deltaP) of 10.8 mmHg at a mean flow rate of 315 ml/min. We conclude that the Pall BC1 filter is a safe and efficient device for use with blood cardioplegia.

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