Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA.
ASAIO J. 2013 Sep-Oct;59(5):474-9. doi: 10.1097/MAT.0b013e31829f0e6e.
Cardiopulmonary bypass (CPB) elicits a systemic inflammatory response. The cause may include surface-induced leukocyte activation and hemolysis. A study was designed to describe the effects of both suction and an air-blood interface independently and in combination on leukocyte and platelet activation, and hemolysis in an in vitro model. Fresh human blood was drawn and tested in four different conditions including control (A), 10 minutes of -600 mm Hg suction (B), 10 minutes of blood exposure to room air at 100 ml/min (C), and 10 minutes of simultaneous suction and air flow (D). Samples were analyzed by flow cytometry (platelets and leukocytes) and plasma-free hemoglobin (PFHb). Leukocyte CD11b expression and platelet P-selectin (CD62P) were analyzed by flow cytometry. In comparison with baseline, granulocytes were significantly activated by air (group C, p = 0.0029) and combination (group D, p = 0.0123) but not by suction alone (group B). Monocytes and platelets were not significantly activated in any group. The PFHb increased significantly in group C (p < 0.001) and group D (p < 0.001). This study suggests that the inflammatory response and associated hemolysis during CPB may be related to air exposure, which could be reduced by minimizing the air exposure of air to blood during cardiotomy suction.
体外模型中，分别和联合应用吸引和空气-血液界面，对白细胞和血小板激活及溶血的影响：心肺转流（CPB）可引起全身炎症反应。其原因可能包括表面诱导的白细胞激活和溶血。本研究旨在描述吸引和空气-血液界面分别和联合应用对体外模型中白细胞和血小板激活及溶血的影响。抽取新鲜人血并在四种不同条件下进行检测，包括对照（A）、-600mmHg 吸引 10 分钟（B）、10 分钟 100ml/min 空气暴露（C）和同时吸引和空气流动 10 分钟（D）。通过流式细胞术（血小板和白细胞）和游离血红蛋白（PFHb）分析样品。通过流式细胞术分析白细胞 CD11b 表达和血小板 P-选择素（CD62P）。与基线相比，空气（C 组，p = 0.0029）和联合（D 组，p = 0.0123）可显著激活粒细胞，但单纯吸引（B 组）不能激活粒细胞。任何一组的单核细胞和血小板均未显著激活。C 组（p < 0.001）和 D 组（p < 0.001）PFHb 显著增加。本研究表明，CPB 期间的炎症反应和相关溶血可能与空气暴露有关，通过在心脏切开吸引时尽量减少空气与血液的接触，可以减少空气暴露。
