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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 252-258, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NC Cavarocchi, JR Pluth, HV Schaff, TA Orszulak, HA Homburger, E Solis, MP Kaye, MS Clancy, J Kolff and GM Deeb
A prospective randomized trial involving 91 patients undergoing
cardiopulmonary bypass compared the effects of bubble oxygenators (with and
without methylprednisolone sodium succinate) and membrane oxygenators on
complement activation and transpulmonary sequestration of leukocytes.
Patients were divided as follows: Group I, 30 patients, bubble oxygenator;
Group II, 31 patients, bubble oxygenator and methylprednisolone sodium
succinate (30 mg/kg); Group III, 30 patients, membrane oxygenator. In Group
I, C3a increased from 323 +/- 171 ng/ml during cardiopulmonary bypass to
1,564 +/- 785 ng/ml at 25 minutes after bypass (p less than 0.0001). A
significant decrease in C3a was found in Groups II and III compared to
Group I (p less than 0.0001). C5a did not change significantly during
cardiopulmonary bypass in any group. Reestablishment of pulmonary
circulation at the end of bypass produced significant transpulmonary
leukocyte sequestration in Group I; the median cell difference was
1,700/microliter. Transpulmonary sequestration was significantly (p less
than 0.0001) less in Group II (median cell difference = 200/microliter) and
in Group III (median cell difference = 400/microliter) than in Group I. We
conclude that cardiopulmonary bypass with a bubble oxygenator alone
initiates significantly (p less than 0.0001) more C3a activation and
leukocyte sequestration than when methylprednisolone sodium succinate (30
mg/kg) is given 20 minutes before the start of cardiopulmonary bypass with
a bubble oxygenator or when a silicone membrane oxygenator is used.
ARTICLES
Complement activation during cardiopulmonary bypass. Comparison of bubble and membrane oxygenators
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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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P. G Loubser and G. J Buffone In vitro generation of C3a anaphylatoxin by an extracorporeal circuit Perfusion, July 1, 1987; 2(3): 219 - 222. [Abstract] [PDF]
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