Prevention of the hypoxic reoxygenation injury with the use of a leukocyte-depleting filter

摘要: Abstract Objectives: Recent studies have shown that an injury occurs when the hypoxic heart is suddenly reoxygenated (as with cardiopulmonary bypass), resulting in myocardial depression, impaired oxygenation, and increased pulmonary vascular resistance. We hypothesize this is, part, due to oxygen-derived radicals produced by activated white cells may therefore be ameliorated limiting leukocytes bypass circuit. Methods: Fifteen neonatal piglets underwent 60 minutes of ventilator hypoxia (inspired oxygen fraction 8% 10%), followed reoxygenation at inspired 100% for 90 minutes. In nine (group 1) our routine circuit was used no modifications, six 2) a leukocyte-depleting filter (Pall BC-1; Pall Biomedical Products Corporation, Glencoe, N.Y.) inserted arterial line lower neutrophil count. Six additional without (cardiopulmonary controls). Postbypass function assessed pressure volume loops, arterial/alveolar ratio, resistance index. Results are expressed as percentage control. Results: By comparison group 1 (reoxygenation filter), undergoing had improved systolic (88% vs 52%; p Conclusions: (1) This study demonstrates major component abruptly caused blood cells; (2) can prevented filter; (3) avoidance improves postbypass function. These data suggest leukocyte depletion should routinely all children operations cyanotic disease or extracorporeal membrane oxygenation. (J Thorac Cardiovasc Surg 1997;113:1081-90)