ORIGINAL ARTICLES  CARDIAC SECTION 

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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

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.