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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 888-899, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
W van Oeveren, MD Kazatchkine, B Descamps-Latscha, F Maillet, E Fischer, A Carpentier and CR Wildevuur
A number of hematologic and immunologic parameters that reflect erythrocyte
and platelet damage and host defense mechanisms against infection were
studied in 20 patients undergoing cardiopulmonary bypass during coronary
operations. The patients were randomly assigned to a group in which a
bubble oxygenator or a hollow-fiber membrane oxygenator was used.
Hemolysis, thrombocytopenia, and significant release of beta
thromboglobulin occurred in patients from the bubble oxygenator group and,
to much lesser extent, in patients from the membrane oxygenator group.
Polymorphonuclear leukocytes and monocytes from bubble oxygenator patients
demonstrated increased generation of reactive oxygen species in the resting
state and in the presence of the stimulating agents
N-formyl-methionyl-leucyl-phenylalanine, concanavalin A, and opsonized
zymosan, as compared with cells from membrane oxygenator patients. No
difference was found between bubble and membrane oxygenator patients in the
time of occurrence or intensity of leukopenia during bypass, of
leukocytosis at the end of bypass, nor in the rate of complement
activation, as assessed by quantitation of plasma C3a antigen. Complement
activation was dependent on the alternative pathway. Immunoglobulin M
concentration significantly decreased during bypass in both groups of
patients. The serum opsonizing capacity for endotoxin and serum
bactericidal activity for Serratia marcescens were decreased in both
groups, mainly because of hemodilution, although they were additionally
affected by bubble oxygenation. Several deleterious hematologic
consequences of cardiopulmonary bypass can be minimized by the use of a
membrane oxygenator. However, complement activation remains a potential
risk factor even in membrane oxygenator patients and requires further
investigation to obtain better hemocompatible materials for cardiopulmonary
bypass circuits.
ARTICLES
Deleterious effects of cardiopulmonary bypass. A prospective study of bubble versus membrane oxygenation
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Y. J. Gu, W. van Oeveren, C. Akkerman, P. W. Boonstra, R. J. Huyzen, and C. R. H. Wildevuur Heparin-coated circuits reduce the inflammatory response to cardiopulmonary bypass Ann. Thorac. Surg., April 1, 1993; 55(4): 917 - 922. [Abstract] [PDF]
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J. Butler, G. M. Rocker, and S. Westaby Inflammatory response to cardiopulmonary bypass Ann. Thorac. Surg., February 1, 1993; 55(2): 552 - 559. [Abstract] [PDF]
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J. Butler, G. L. Chong, MMed(Anaes), R. J. Baigrie, R. Pillai, S. Westaby, and G. M. Rocker Cytokine responses to cardiopulmonary bypass with membrane and bubble oxygenation Ann. Thorac. Surg., May 1, 1992; 53(5): 833 - 838. [Abstract] [PDF]
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Y. J. Gu, W. van Oeveren, P. W. Boonstra, J. de Haan, and C. R. H. Wildevuur Leukocyte activation with increased expression of CR3 receptors during cardiopulmonary bypass Ann. Thorac. Surg., May 1, 1992; 53(5): 839 - 843. [Abstract] [PDF]
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A. M Horton and W. Butt Pump-induced haemolysis: is the constrained vortex pump better or worse than the roller pump? Perfusion, April 1, 1992; 7(2): 103 - 108. [Abstract] [PDF]
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P. Boonstra, C. Akkerman, I. Tigchelaar, Y. Gu, R. Huyzen, and A. Eijgelaar Heparin surface treatment does not impair gas and heat transfer of an extracorporeal circuit Perfusion, April 1, 1992; 7(2): 109 - 114. [Abstract] [PDF]
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Y. J. Gu, Y. S. Wang, B. Y. Chiang, X. D. Gao, C. X. Ye, and C. R. H. Wildevuur Membrane oxygenator prevents lung reperfusion injury in canine cardiopulmonary bypass Ann. Thorac. Surg., April 1, 1991; 51(4): 573 - 578. [Abstract] [PDF]
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J. L. Svennevig, V. Videm, E. Fosse, T. E. Mollnes, P. Garred, and with technical assistance from Hans Nielsen Complement activation with bubble and membrane oxygentors in aortocorpnary bypass grafting Ann. Thorac. Surg., September 1, 1990; 50(3): 387 - 391. [Abstract] [PDF]
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T. Gourlay, J. Fleming, K. Taylor, and M. Aslam Evaluation of a range of extracorporeal membrane oxygenators Perfusion, April 1, 1990; 5(2): 117 - 133. [PDF]
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R. S. Bonser, J. R. Dave, E. T. Davies, L. John, P. Taylor, H. Gaya, S. C. Lennox, and D. Vergani Reduction of complement activation during bypass by prime manipulation Ann. Thorac. Surg., February 1, 1990; 49(2): 279 - 283. [Abstract] [PDF]
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M. Leijala, K. Peltola, M. Aronen, S. Meri, and I. Louhimo Comparison of hollow fibre membrane oxygenators during cardiopulmonary bypass in children: Dideco Masterflo versus Terumo Capiox II Perfusion, January 1, 1990; 5(1): 33 - 43. [Abstract] [PDF]
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M. Sellman, T. Ivert, M. Blomback, and B. Semb Haematological effects of a depth absorption arterial line filter during extracorporeal circulation Perfusion, October 1, 1989; 4(4): 255 - 264. [Abstract] [PDF]
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F. Alajmo, G. Calamai, A. M. Perna, G. Melissano, P. Pretelli, M. F. Palmarini, F. Carbonetto, D. Noferi, V. Boddi, A. Palminiello, et al. High-Dose Aprotinin: Hemostatic Effects in Open Heart Operations Ann. Thorac. Surg., October 1, 1989; 48(4): 536 - 539. [Abstract] [PDF]
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 A. Belboul, N. A. Khaja, P. Bergman, D. Roberts, and G. William-Olsson Postoperative Morbidity Following Red Cell Deformability Changes During Cardiopulmonary Bypass Using Bubble and Membrane Oxygenators Vascular and Endovascular Surgery, July 1, 1989; 23(4): 258 - 264. [Abstract] [PDF]
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P. Menasche and A. Piwnica Free radicals and myocardial protection: A surgical viewpoint Ann. Thorac. Surg., June 1, 1989; 47(6): 939 - 945. [Abstract] [PDF]
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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. Paccagnella, S. De Angeli, G. Caenaro, C. Zussa, C. Valfre, and G. Simini Cardiopulmonary Bypass in Leukemic Patients Ann. Thorac. Surg., May 1, 1988; 45(5): 588 - 588. [PDF]
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D. Pearson Blood gas control during cardiopulmonary bypass Perfusion, April 1, 1988; 3(2): 113 - 133. [PDF]
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W. van Oeveren, J. Dankert, and C. R. H. Wildevuur Bubble Oxygenation and Cardiotomy Suction Impair the Host Defense during Cardiopulmonary Bypass: A Study in Dogs Ann. Thorac. Surg., November 1, 1987; 44(5): 523 - 528. [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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T. S. Padayachee, S. Parsons, R. Theobold, J. Linley, R. G. Gosling, and P. B. Deverall The Detection of Microemboli in the Middle Cerebral Artery during Cardiopulmonary Bypass: A Transcranial Doppler Ultrasound Investigation Using Membrane and Bubble Oxygenators Ann. Thorac. Surg., September 1, 1987; 44(3): 298 - 302. [Abstract] [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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W. van Oeveren, J. Dankert, W. Wildevuur, and C. R. H. Wildevuur Prophylactic Antibiotic Treatment Prevents Infection after Cardiopulmonary Bypass: A Study in Dogs Ann. Thorac. Surg., May 1, 1987; 43(5): 544 - 549. [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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M. Kurusz, B. D Butler, D. Pearson, M. Holden, S. Poslad, A. Murray, P. Waterhouse, G. Wright, and A. Furness Correspondence Perfusion, July 1, 1986; 1(3): 213 - 219. [PDF]
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D. T Pearson, M. P Holden, S. J Poslad, A. Murray, and P. S Waterhouse A clinical evaluation of the performance characteristics of one membrane and five bubble oxygenators: gas transfer and gaseous microemboli production Perfusion, January 1, 1986; 1(1): 15 - 27. [Abstract] [PDF]
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D. Wheeldon, D. Bethune, and R. Gill Perfusion for cardiac transplantation Perfusion, January 1, 1986; 1(1): 57 - 61. [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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