Discipline of Anesthesiology-Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil,
Inflammation. 2014 Feb;37(1):196-204. doi: 10.1007/s10753-013-9730-z.
Cardiopulmonary bypass (CPB) is related to inflammatory response and pulmonary dysfunction. The aim of this study was to evaluate the effects of CPB leukocyte filtration on inflammation and lung function after coronary artery bypass grafting (CABG). A prospective randomized study was performed to compare CABG patients undergoing CPB leukocyte filtration (n = 9) or standard CPB (n = 11). Computed tomography, oxygenation, leukocyte count, hemodynamic data, PaO2/FiO2, shunt fraction, interleukins, elastase, and myeloperoxidase were evaluated. Data were analyzed using two-factor ANOVA for repeated measurements. The filtered group showed lower neutrophil counts up to 50 min of CPB, lower shunt fraction up to 6 h after surgery, and lower levels of IL-10 at the end of surgery (p < 0.05). There was no statistically significant difference between groups related to other parameters. Leukodepletion during CPB results in neutrophil sequestration by a short time, decreased IL-10 serum levels, and lower worsening of lung function only temporarily.
体外循环(CPB)与炎症反应和肺功能障碍有关。本研究旨在评估冠状动脉旁路移植术(CABG)中 CPB 白细胞滤过对炎症和肺功能的影响。进行了一项前瞻性随机研究,比较了接受 CPB 白细胞滤过(n = 9)或标准 CPB(n = 11)的 CABG 患者。评估了计算机断层扫描、氧合、白细胞计数、血流动力学数据、PaO2/FiO2、分流分数、白细胞介素、弹性蛋白酶和髓过氧化物酶。使用重复测量的两因素方差分析对数据进行分析。过滤组在 CPB 期间直到 50 分钟时中性粒细胞计数较低,手术后 6 小时分流分数较低,手术结束时 IL-10 水平较低(p < 0.05)。两组在其他参数方面无统计学差异。CPB 期间的白细胞去除导致中性粒细胞暂时被隔离,血清 IL-10 水平降低,肺功能恶化暂时减轻。