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The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 370-377, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
DE Hammerschmidt, DF Stroncek, TK Bowers, CJ Lammi-Keefe, DM Kurth, A Ozalins, DM Nicoloff, RC Lillehei, PR Craddock and HS Jacob
Complement activation and pulmonary leukostasis with neutropenia occur in
hemodialysis and filtration leukapheresis, with attendant pulmonary
dysfunction. Wondering whether similar phenomena might attend
cardiopulmonary bypass (CPB), we studied 34 patients undergoing coronary
artery bypass operations. As in the other extracorporeal circulation
systems, neutropenia (mean 44.7% +/- 4.3% SEM of prebypass PMN count)
occurred during the first half hour of bypass and then a rebound
neutrophilia followed. CH50 and C3H50 fell 22% to 25% (p for CH50 less than
0.01) during bypass, but C3 conversion and C5a were not demonstrable in
patient plasmas. Nonetheless, polymorphonuclear neutrophils (PMNs)
harvested late in bypass showed low adherence to nylon and selective
chemotactic and aggregative insensitivity to C5a-- functional aberrations
which are seen after exposure to activated complement. Furthermore, smaller
infusions of activated complement into animals produced neutropenia than
were required to achieve a detectable [C5a] in the plasma. We conclude that
neutropenia during CPB probably results from complement activation below
the threshold of detection; complement-stimulated PMNs deserve study as
possible mediators of tissue injury occurring during CPB.
ARTICLES
Complement activation and neutropenia occurring during cardiopulmonary bypass
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D.T. Pearson and B. McArdle Haemocompatibility of membrane and bubble oxygenators Perfusion, January 1, 1989; 4(1): 9 - 24. [Abstract] [PDF]
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A T. Pezzella, A. Ascioti, and P. Ricardi Noncardiogenic pulmonary oedema following cardiopulmonary bypass: report of two cases and review of the literature Perfusion, January 1, 1988; 3(1): 21 - 28. [Abstract] [PDF]
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W. van Oeveren and C. Wildevuur Review article : Blood compatibility of cardiopulmonary bypass circuits Perfusion, October 1, 1987; 2(4): 237 - 244. [PDF]
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B. Glenville Review article : Cardiac surgery using the patient's lungs as the oxygenator Perfusion, July 1, 1987; 2(3): 161 - 166. [PDF]
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A. Gaspardone, M. Ciavolella, D. Mercogliano, B. Marino, L. Chiariello, and G. Carlizzi Complement activation by different cardiopulmonary bypass priming solutions Perfusion, October 1, 1986; 1(4): 255 - 260. [Abstract] [PDF]
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L. L Mickleborough, G. Arnold, and R. C-J Chiu Complement consumption during cardiopulmonary bypass: bubble versus membrane oxygenators Perfusion, October 1, 1986; 1(4): 261 - 269. [Abstract] [PDF]
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D. T Pearson, B. McArdle, S. J Poslad, and A. Murray A clinical evaluation of the performance characteristics of one membrane and five bubble oxygenators: haemocompatibility studies Perfusion, January 1, 1986; 1(2): 81 - 98. [Abstract] [PDF]
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