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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2002 April;43(2):161-5

lingua: Inglese

Concentrated platelets harvesting before cardiopulmonary bypass improved cardiac and pulmonary function

Kunitomo R., Kitamura N., Utoh J., Nishimura K., Sakaguchi H., Uemura S., Hagiwara S.

From The ­First Depart­ment of Sur­gery Kuma­moto Uni­ver­sity ­School of Med­i­cine, Kuma­moto, ­Japan


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Back­ground. Seques­tra­tion of con­cen­trated plate­lets (P-con) ­during car­di­o­pul­mo­nary ­bypass (CPB) has ­been per­formed to pre­serve ­platelet func­tion ­after car­diac sur­gery. ­Since P-con ­also har­vests leu­ko­cytes simul­ta­ne­ously, ­there ­might be a pos­sibility ­that the inflam­ma­tory ­effects or ­ischemia-reper­fu­sion inju­ries asso­ciated ­with CPB, ­such as a car­diac or pul­mo­nary dys­func­tion ­after car­diac sur­gery, are ­reduced ­with its use.
­Methods. We ret­ro­spec­tively eval­u­ated 53 ­patients who under­went car­diac sur­gery ­after the intro­duc­tion of the P-con tech­nique at our insti­tute. ­There ­were 20 ­patients in the P-con ­group and 33 ­patients in the con­trol ­group in ­whom con­cen­trated ­platelet ­were not har­vested.
­Results. The ­patients char­ac­ter­is­tics and pre­op­er­a­tive car­diac and pul­mo­nary func­tion did not ­differ ­between the two ­groups. The per­cent­ages of plate­lets and leu­ko­cytes seques­trated ­were 20.2±5.4% and 8.5±3.9% of the ­total esti­mated cir­cu­lating ­cell ­counts, respec­tively. ­There ­were no sig­nif­i­cant dif­fer­ences in the post­op­er­a­tive ­dose of dop­a­mine ­used, car­diac ­index, pul­mo­nary cap­il­lary ­wedge pres­sure or intu­ba­tion ­period ­between the two ­groups. How­ever, the ­stroke ­volume ­index (p=0.005), ­left ven­tric­ular ­stroke ­work ­index (p=0.002), and ­ratio of the arte­rial ­oxygen ten­sion to the ­inspired frac­tion of ­oxygen on extu­ba­tion (p=0.02) ­were sig­nif­i­cantly ­greater in the P-con ­group as com­pared ­with ­those in the con­trol.
Con­clu­sions. P-con ­improved car­diac and pul­mo­nary func­tion ­after CPB. Simul­ta­neous seques­tra­tion of plate­lets and leu­ko­cytes by P-con ­during CPB may con­tribute to the improve­ment of car­diac and pul­mo­nary func­tion ­after car­diac sur­gery.

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