Effects of leukocyte depletion from the arterial line during cardiopulmonary bypass on postoperative pulmonary function

Luo Lin; Wang Dan; Li Meixia; Chen Meizhu

doi:10.13498/j.cnki.chin.j.ecc.2019.01.09

Abstract：Objective To evaluate the effects of leukocyte depletion in the arterial line during cardiopulmonary bypass on postoperative pulmonary function in patients after cardiac surgery. Methods Forty patients aged 22-65 yr, with American Society of Anesthesiologists Physical Status Ⅱ or Ⅲ, scheduled for elective cardiac valve replacement surgery with CPB, were divided into two groups (n = 20 each) by using a random number table. In experimental group (group LD), blood was filtered with a leukocyte depleting filter placed in the arterial line of the CPB circuit since the start of rewarming until the termination of CPB. Blood samples were taken before CPB (T1), ten minutes after aortic unclamping (T2), at the end of CPB (T3), 12 and 24 h after T3 (T4-5) to examine blood components and serum levels of TNF-α, IL-6, MDA and SOD. Meanwhile respiratory ventilation parameters and blood gas analyses were also recorded to calculate the static pulmonary compliance (Cstat), oxygenation index (OI) and respiratory index (RI). The mechanical ventilation time, ICU stay time, incidence of oxygen desaturation and pulmonary infection were compared between the two groups after surgery. Results Compared with control group (group C), WBC and NEU counts significantly decreased at T3-5 in group LD (P ＜0.05). The serum concentrations of TNF-α, IL-6, MDA and RI significantly decreased at T2-5, while the SOD concentrations increased at T2-5 (P ＜0.05). Cstat and OI increased at T3-5 in group LD (P ＜0.05), while the the mechanical ventilation time, ICU stay time significantly decreased in group LD (P ＜0.05). Conclusion An arterial line leukocyte depletion during cardiopulmonary bypass can inhibit inflammatory responses and improve the postoperative pulmonary function after cardiopulmonary bypass.