OBJECTIVE:To investigate the effect of the use of on-pump leukocyte filtration on neurological and blood-brain barrier damage in the late phase of inflammatory reaction after cardiopulmonary bypass (CPB). METHODS:Forty consecutive patients undergoing elective coronary artery bypass grafting (CABG) were randomly assigned to two groups, with the use of a leukocyte filter in the CPB circuit (study group, n=20) or with a standard CPB circuit (control group, n=20). Blood samples were collected before sternotomy, after aortic unclamping and at 1, 3, 6 24 and 48 hours after CPB. Concentrations of S-100ßß protein, matrix metalloproteinase (MMP) MMP-2, MMP-9 and neurospecific enolase (NSE) were evaluated by dot blotting. Specific antibodies determinations against S-100ßß, MMP-2, MMP-9 and NSE, chemoluminescence detections and densitometric quantifications were performed. RESULTS:Demographic characteristics and operative data were similar in the two groups. No major neurological events occurred in either group and no differences in ICU stay or in hospital stay were observed. At statistical analysis (ANOVA within-between groups), patients in the study group showed lower concentrations of S-100 and NSE at 24 and 48 hours. Concentrations of MMP2 and MMP9 were higher in the study group at any time. CONCLUSIONS:In this prospective, randomised study, the use of a leukodepleting filter in the CPB circuit has demonstrated to lower the concentration of NSE and S-100 in the late phase of inflammatory reaction, as compared to standard CPB circuit.
Leukocyte filtration effect on neurological inflammation after on-pump coronary surgery
FERRARESE, SANDRO;VIGETTI, DAVIDE;CANTORE, CRISTIANO;BRUNO, VITO DOMENICO;SALA, ANDREA ANTONIO
2010-01-01
Abstract
OBJECTIVE:To investigate the effect of the use of on-pump leukocyte filtration on neurological and blood-brain barrier damage in the late phase of inflammatory reaction after cardiopulmonary bypass (CPB). METHODS:Forty consecutive patients undergoing elective coronary artery bypass grafting (CABG) were randomly assigned to two groups, with the use of a leukocyte filter in the CPB circuit (study group, n=20) or with a standard CPB circuit (control group, n=20). Blood samples were collected before sternotomy, after aortic unclamping and at 1, 3, 6 24 and 48 hours after CPB. Concentrations of S-100ßß protein, matrix metalloproteinase (MMP) MMP-2, MMP-9 and neurospecific enolase (NSE) were evaluated by dot blotting. Specific antibodies determinations against S-100ßß, MMP-2, MMP-9 and NSE, chemoluminescence detections and densitometric quantifications were performed. RESULTS:Demographic characteristics and operative data were similar in the two groups. No major neurological events occurred in either group and no differences in ICU stay or in hospital stay were observed. At statistical analysis (ANOVA within-between groups), patients in the study group showed lower concentrations of S-100 and NSE at 24 and 48 hours. Concentrations of MMP2 and MMP9 were higher in the study group at any time. CONCLUSIONS:In this prospective, randomised study, the use of a leukodepleting filter in the CPB circuit has demonstrated to lower the concentration of NSE and S-100 in the late phase of inflammatory reaction, as compared to standard CPB circuit.
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