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J Thorac Cardiovasc Surg 2001;122:402
© 2001 The American Association for Thoracic Surgery

Letters to the Editor

Use of pH-stat strategy for hypothermic circulatory arrest might obviate the need for leukocyte filtration

Tadaomi-Alfonso Miyamoto, MD 1, Koho-Julio Miyamoto, MD, PhD 2

1Research Department, Kokura Memorial Hospital, 1-1 Kifune-cho, Kokura-kitaku Kitakyushu-shi 802-8555, Japan

2Assistant Professor II, Department of Physiology, The University of Ryukyus School of Medicine, Okinawa, Japan

To the Editor:

We do not doubt the role leukocytes play in reperfusion injury, brain included. Rimpiläinen and associatesGo 1 observed protection by removing leukocytes (with a filter in the cardiopulmonary bypass line) before and during hypothermic circulatory arrest and after reperfusion. However, cytokines were elevated whether filtered or not. The work fails to address the issue of why and when cytokines were produced, which we believe lies in the pH management of the hypothermic perfusion, although the experimental protocol is not designed to answer that assumption. The authors have added one more indication of the deleterious effects of alpha-stat hypothermic perfusion but have failed to recognize it.

12/8/115236

doi:10.1067/mtc.2001.115236

Reference

  1. Rimpiläinen J, Pokela M, Kiviluoma K, Anttila V, Vainionpää V, Hirvonen J, et al. Leukocyte filtration improves brain protection after a prolonged period of hypothermic circulatory arrest: a study in a chronic porcine model. J Thorac Cardiovasc Surg. 2000;120:1131-41.[Abstract/Free Full Text]




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