JTCS Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
James J. Jaggers
Ross M. Ungerleider
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Langley, S. M.
Right arrow Articles by Ungerleider, R. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Langley, S. M.
Right arrow Articles by Ungerleider, R. M.

J Thorac Cardiovasc Surg 2000;119:1262-1269
© 2000 The American Association for Thoracic Surgery

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

THE EFFECTS OF A LEUKOCYTE-DEPLETING FILTER ON CEREBRAL AND RENAL RECOVERY AFTER DEEP HYPOTHERMIC CIRCULATORY ARREST

Stephen M. Langley, MD, FRCS, Paul J. Chai, MD, Steven S. Tsui, MD, FRCS, James J. Jaggers, MD, Ross M. Ungerleider, MD

From the Department of Pediatric Cardiac Surgery, Duke University Medical Center, Durham, NC.

Address for reprints: Stephen Langley, MD, Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, Hampshire, SO16 6YD, United Kingdom (E-mail: StephenLangley{at}dial.pipex.com ).

Objective: The purpose of this study was to determine the effects of a leukocyte-depleting filter on cerebral and renal recovery after deep hypothermic circulatory arrest.
Methods: Sixteen 1-week-old piglets underwent cardiopulmonary bypass, were cooled to 18°C, and underwent 60 minutes of circulatory arrest, followed by 60 minutes of reperfusion and rewarming. Global and regional cerebral blood flow, cerebral oxygen metabolism, and renal blood flow were determined before cardiopulmonary bypass, after the institution of cardiopulmonary bypass, and at 1 hour of deep hypothermic circulatory arrest. In the study group (n = 8 piglets), a leukocyte-depleting arterial blood filter was placed in the arterial side of the cardiopulmonary bypass circuit.
Results: With cardiopulmonary bypass, no detectable change occurred in the cerebral blood flow, cerebral oxygen metabolism, and renal blood flow in either group, compared with before cardiopulmonary bypass. In control animals, after deep hypothermic circulatory arrest, blood flow was reduced to all regions of the brain (P < .004) and the kidneys (P = .02), compared with before deep hypothermic circulatory arrest. Cerebral oxygen metabolism was also significantly reduced to 60.1% ± 11.3% of the value before deep hypothermic circulatory arrest (P = .001). In the leukocyte-depleting filter group, the regional cerebral blood flow after deep hypothermic circulatory arrest was reduced, compared with the value before deep hypothermic circulatory arrest (P < .01). Percentage recovery of cerebral blood flow was higher in the leukocyte filter group than in the control animals in all regions but not significantly so (P > .1). The cerebral oxygen metabolism fell to 66.0% ± 22.3% of the level before deep hypothermic circulatory arrest, which was greater than the recovery in the control animals but not significantly so (P = .5). After deep hypothermic circulatory arrest, the renal blood flow fell to 81.0% ± 29.5% of the value before deep hypothermic circulatory arrest (P = .06). Improvement in renal blood flow in the leukocyte filter group was not significantly greater than the recovery to 70.2% ± 26.3% in control animals (P = .47).
Conclusions: After a period of deep hypothermic circulatory arrest, there is a significant reduction in cerebral blood flow, cerebral oxygen metabolism, and renal blood flow. Leukocyte depletion with an in-line arterial filter does not appear to significantly improve these findings in the neonatal piglet.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
E. J. Hickey, X. You, V. Kaimaktchiev, and R. M. Ungerleider
Hypoxemic reperfusion exacerbates the neurological injury sustained during neonatal deep hypothermic circulatory arrest: a model of cyanotic surgical repair
Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 906 - 914.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. Hickey, T. Karamlou, X. You, C. Komanapalli, T. Person, K. Wehrley, and R. Ungerleider
The Use of a Miniaturized Circuit and Bloodless Prime To Avoid Cerebral No-Reflow After Neonatal Cardiopulmonary Bypass
Ann. Thorac. Surg., March 1, 2007; 83(3): 895 - 901.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. Hickey, T. Karamlou, J. You, and R. M. Ungerleider
Effects of Circuit Miniaturization in Reducing Inflammatory Response to Infant Cardiopulmonary Bypass by Elimination of Allogeneic Blood Products
Ann. Thorac. Surg., June 1, 2006; 81(6): S2367 - S2372.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T.-Y. Hsia and P. J. Gruber
Factors Influencing Neurologic Outcome After Neonatal Cardiopulmonary Bypass: What We Can and Cannot Control
Ann. Thorac. Surg., June 1, 2006; 81(6): S2381 - S2388.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Amir, C. Ramamoorthy, R. K. Riemer, V. M. Reddy, and F. L. Hanley
Neonatal Brain Protection and Deep Hypothermic Circulatory Arrest: Pathophysiology of Ischemic Neuronal Injury and Protective Strategies
Ann. Thorac. Surg., November 1, 2005; 80(5): 1955 - 1964.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. M. Ungerleider and J. W. Gaynor
The Boston Circulatory Arrest Study: An analysis
J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1256 - 1261.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. H. Habib, A. Zacharias, T. A. Schwann, C. J. Riordan, S. J. Durham, and A. Shah
Adverse effects of low hematocrit during cardiopulmonary bypass in the adult: Should current practice be changed?
J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1438 - 1450.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Haverich and C. Hagl
Organ protection during hypothermic circulatory arrest
J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 460 - 462.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. T.M. Tang, C. Alexiou, J. Hsu, S. V. Sheppard, M. P. Haw, and S. K. Ohri
Leukodepletion reduces renal injury in coronary revascularization: a prospective randomized study
Ann. Thorac. Surg., August 1, 2002; 74(2): 372 - 377.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
S J Morris
Leukocyte reduction in cardiovascular surgery
Perfusion, September 1, 2001; 16(5): 371 - 380.
[PDF]

Home page
 Anesth. Analg.Home page
P. Sekaran, M. Ehrlich, C. Hagl, M. L. Leavitt, R. Jacobs, J. N. McCullough, and E. Bennett-Guerrero
A Comparison of Complete Blood Replacement With Varying Hematocrit Levels on Neurological Recovery in a Porcine Model of Profound Hypothermic (<5{degrees}C) Circulatory Arrest
Anesth. Analg., February 1, 2001; 92(2): 329 - 334.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The American Association for Thoracic Surgery.