HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Juhani Rämö Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ilmakunnas, M. Articles by Repo, H. Search for Related Content PubMed PubMed Citation Articles by Ilmakunnas, M. Articles by Repo, H. Related Collections Extracorporeal circulation

J Thorac Cardiovasc Surg 2005;129:851-859
© 2005 The American Association for Thoracic Surgery

Evolving Technology

Activation of neutrophils and monocytes by a leukocyte-depleting filter used throughout cardiopulmonary bypass

^a Department of Bacteriology and Immunology, University of Helsinki, Finland
^b the Department of Anesthesia and Intensive Care Medicine, University of Helsinki, Finland
^c the Department of Thoracic and Cardiovascular Surgery, University of Helsinki, Finland
^d the Department of Clinical Chemistry, University of Helsinki, Finland
^e the Division of Infectious Diseases, University of Helsinki, Finland

Received for publication February 13, 2004; revisions received June 29, 2004; accepted for publication July 14, 2004.

^_* Address for reprints: Eero Pesonen, MD, PhD, Department of Anesthesia and Intensive Care Medicine, University Hospital of Helsinki, PL 340, 000290 HUS, Helsinki, Finland (E-mail: eero.pesonen{at}kolumbus.fi).

OBJECTIVE: Cardiopulmonary bypass elicits systemic inflammation. Depletion of circulating leukocytes might alleviate inflammatory response. We studied the effects of a leukocyte-depleting filter on phagocyte activation during cardiopulmonary bypass.

METHODS: Fifty patients undergoing coronary artery bypass grafting were randomly allocated into an arterial line leukocyte filter group (n = 25) with a Pall LeukoGuard 6 leukocyte-depleting filter (LG6; Pall Biomedical, Portsmouth, United Kingdom) and a control group without any filter (n = 25). Blood sampling took place from arterial line at predetermined time points. In the filter group, the sample was taken immediately before the filter; to evaluate activation at the site, an additional sample was taken immediately after the filter. CD11b/CD18 and L-selectin expressions and basal production of hydrogen peroxide were determined with whole-blood flow cytometry, and plasma lactoferrin level was determined with enzyme-linked immunosorbent assay.

RESULTS: Neutrophil CD11b expression was higher in the filter group than in the control group (P < .001). Likewise, monocyte CD11b expression, neutrophil hydrogen peroxide production, and lactoferrin plasma levels were all significantly higher, whereas neutrophil and monocyte counts and neutrophil L-selectin expression were all significantly lower in the filter group (all P < .001). At 5 minutes of CPB, CD11b expression increased across the filter on neutrophils (median difference 197 relative fluorescence units, range 45–431 relative fluorescence units, P < .001) and monocytes (median difference 26 relative fluorescence units, range –68–111 relative fluorescence units, P < .001).

CONCLUSION: The LG6 arterial line leukocyte filter is ineffective in its principal task of diminishing phagocyte activation during cardiopulmonary bypass.

This article has been cited by other articles:

				K. Tao, Q. An, K. Lin, R. C. Lui, X. Wu, J. Zhou, and L. Du Which is better to preserve pulmonary function: Short-term or prolonged leukocyte depletion during cardiopulmonary bypass? J. Thorac. Cardiovasc. Surg., December 1, 2009; 138(6): 1385 - 1391. [Abstract] [Full Text] [PDF]

				V. A. Ferraris Reply Ann. Thorac. Surg., March 1, 2008; 85(3): 1139 - 1139. [Full Text] [PDF]

				The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]

				O. Warren, C. Alexiou, R. Massey, D. Leff, S. Purkayastha, J. Kinross, A. Darzi, and T. Athanasiou The effects of various leukocyte filtration strategies in cardiac surgery Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 665 - 676. [Abstract] [Full Text] [PDF]

				H. Alaoja, E. Niemela, V. Anttila, S. Dahlbacka, J. Makela, K. Kiviluoma, P. Laurila, T. Kaakinen, and T. Juvonen Leukocyte filtration to decrease the number of adherent leukocytes in the cerebral microcirculation after a period of deep hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1339 - 1347. [Abstract] [Full Text] [PDF]

				S. Gunaydin, K. McCusker, V. Vijay, S. Isbir, T. Sari, M. A. Onur, A. Gurpinar, A. Sezgin, M. F Sargon, T. Tezcaner, et al. Comparison of polymethoxyethylacrylate-coated circuits with leukocyte filtration and reduced heparinization protocol on heparin-bonded circuits in different risk cohorts Perfusion, November 1, 2006; 21(6): 329 - 342. [Abstract] [PDF]

				A. Weerasinghe, T. Athanasiou, P. Philippidis, J. Day, K. Mandal, O. Warren, J. Anderson, and K. Taylor Platelet-monocyte pro-coagulant interactions in on-pump coronary surgery Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 312 - 318. [Abstract] [Full Text] [PDF]

				D. C Whitaker, J. Stygall, M. J. Harrison, I. J Mackie, M. Kemp, J. Hooper, W. B Pugsley, and S. P Newman Leucocyte-depleting arterial line filtration does not reduce myocardial injury assessed by Troponin T during routine coronary artery bypass grafting using crossclamp fibrillation Perfusion, January 1, 2006; 21(1): 55 - 60. [Abstract] [PDF]

				D. Whitaker Uses of the leukocyte-depleting filter J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 952 - 953. [Full Text] [PDF]