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The Journal of Cardiovascular Surgery 2003 April;44(2):197-204

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Does leukodepletion during elective cardiac surgery really influence the overall clinical outcome?

Efstathiou A., Vlachveis M., Tsonis G., Asteri T., Psarakis A., Fessatidis I. T.

Cardiothoracic Surgery Department George Papanikolaou General Regional Hospital Exohi, Thessaloniki, Greece


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Aim. We exam­ined the ­impact of leu­ko­cyte fil­tra­tion ­during the ­entire ­bypass ­time on post­op­er­a­tive leu­ko­cy­tosis, per­i­op­er­a­tive hem­or­rhage and ­overall clin­ical out­come in ­patients under­going elec­tive car­diac sur­gery.
­Methods. ­Eighty ­patients who elec­tively under­went car­diac sur­gery ­were ran­domly allo­cated to a leu­ko­cyte deple­tion ­group (n=40) or a con­trol ­group (n=40). In ­patients of the leu­ko­cyte deple­tion ­group an arte­rial ­line ­filter ­with leu­ko­cyte ­depleting ­capacity (­Pall LG6) was ­applied ­instead of a stan­dard arte­rial ­line ­filter. ­White ­blood ­cells and ­platelet ­count ­were esti­mated pre­op­er­a­tively and at var­ious ­times post­op­er­a­tively. Post­op­er­a­tive clin­ical out­comes ­were ­also ­recorded.
­Results. ­Repeated ­measure anal­ysis of var­i­ance ­between ­groups ­showed ­that leu­ko­cyte ­counts ­were sig­nif­i­cantly ­lower in the deple­tion ­group post­op­er­a­tively (p=0.005) ­whereas no dif­fer­ence was ­found in the ­platelet ­counts (p=0.37). The cat­e­chol­a­mine ­dose ­required at the ­time of ­weaning ­from car­di­o­pul­mo­nary ­bypass and ­during the ­first 12 post­op­er­a­tive ­hours was ­found to be ­lower in the leu­kod­e­ple­tion ­group (p=0.027 and p=0.021, respec­tively). Fur­ther­more leu­ko­de­pleted ­patients ­showed a tran­sient improve­ment in the oxy­gen­a­tion ­index (p=0.029) and a ­shorter ­period of mechan­ical ven­ti­la­tion (p<0.001). The inci­dences of post­op­er­a­tive com­pli­ca­tions ­were sim­ilar ­between the ­groups. No dif­fer­ence was ­observed in ­regard to post­op­er­a­tive ­blood ­loss (p=0.821) and ­amount of ­packed red ­blood ­cells ­required for trans­fu­sion ­during the ­first 24 ­hours (p=0.846). The dura­tion of inten­sive ­care ­unit ­stay and of hos­pi­tal­iza­tion ­were sim­ilar ­between the ­groups.
Con­clu­sion. Leu­ko­cyte deple­tion con­trib­utes to ­early post­op­er­a­tive improve­ment in ­heart and ­lung func­tion but ­does not influ­ence sig­nif­i­cantly the ­overall clin­ical out­come of ­patients under­going elec­tive car­diac sur­gery.

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