Complement activation and neutropenia occurring during cardiopulmonary bypass

Hammerschmidt, Dale E.; Stroncek, David F.; Bowers, Timothy K.; Lammi‐Keefe, Carol J.; Kurth, Doris M.; Ozalins, Andrew; Nicoloff, Demétre M.; Lillehei, Richard C.; Craddock, Philip R.; Jacob, Harry S.

doi:10.1016/s0022-5223(19)37600-7

Cited by 297 publications

(40 citation statements)

References 16 publications

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“…Damaging actions of activated complement components may be via direct tissue damage or indirectly by activation of neutrophils with release of proteinases such as elastase and generation of free oxygen radicals (39,42,5 1). Studies by Hammer-Schmidt et al (39) in humans and rabbits and by Hohn et al (42) in rabbits support the hypothesis that activated complement components stimulate neutrophils and cause a number of changes in neutrophil function. Hammerschmidt et al (39) conclude that "neutropenia occumng during cardiopulmonary by-pass most likely results from complement activation."…”

Section: The Complement Systemmentioning

confidence: 73%

“…Studies by Hammer-Schmidt et al (39) in humans and rabbits and by Hohn et al (42) in rabbits support the hypothesis that activated complement components stimulate neutrophils and cause a number of changes in neutrophil function. Hammerschmidt et al (39) conclude that "neutropenia occumng during cardiopulmonary by-pass most likely results from complement activation." Their data also suggest that complement stimulated polymorphonuclear leukocytes (PMNs) might be involved in the "postperfusion lung" syndrome that is sometimes a complication of cardiopulmonary bypass (39).…”

Section: The Complement Systemmentioning

confidence: 73%

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Pharmacology of Aprotinin and Efficacy During Cardiopulmonary Bypass

Emerson

1989

Cardiovascular Drug Reviews

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Section: The Complement Systemmentioning

confidence: 73%

Section: The Complement Systemmentioning

confidence: 73%

Pharmacology of Aprotinin and Efficacy During Cardiopulmonary Bypass

Emerson

1989

Cardiovascular Drug Reviews

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“…The mechanism behind this activation is not clear, but several factors may be involved. The graft surface could act as an activator, comparable to the activation seen in connection with haemodialysis (6) , cardiopulmonary bypass (14,15) and membrane plasma separation (16).…”

Section: Discussionmentioning

confidence: 96%

Granulocytes in bronchial lavage fluid after major vascular surgery

Fosse

Opdahl

Sunde

et al. 1987

Acta Anaesthesiol Scand

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Increased numbers of polymorphonuclear granulocytes (PMN) in the airways, as measured by PMN content in bronchial lavage fluid (P less than 0.01), were found 3 h postoperatively in ten patients undergoing surgery for lumbar aortic aneurysms. An increase in plasma levels of the complement split product C3dg from 6 (0-19) AU/ml preoperatively to 20 (13-50) AU/ml 3 h after surgery (P less than 0.01), indicates an activation of the complement cascade. These changes were not accompanied by increased elastase activity in the bronchial lavage fluid or by major changes in pulmonary blood gas exchange or vascular resistance, indicating that massive PMN activation, analogous to that proposed in adult respiratory distress syndrome (ARDS) had not taken place. In conclusion, complement system activation and migration of PMN into the airways, as seen in connection with major vascular surgery, does not seem to contribute to ARDS-type pulmonary dysfunction.

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“…These leukocyte functional changes are not unique to CPB and are reported in other extracorporeal systems, like filtration leukapheresis and hemodialysis (8,9), where they are considered to be related to complement activation. Consequently, neutropenia during CPB was more recently thought to be a result of the complement activation induced by the interaction of blood with the materials of the extracorporeal circuit (10). As a parameter of complement catabolism, the levels of C3d were measured.…”

Section: Discussionmentioning

confidence: 99%

Changes in Neutrophil Oxidative Potential in Patients Undergoing Cardiopulmonary Bypass with Polypropylene Hollow Fiber Oxygenators

Roccatello¹,

Formica²,

Cavalli³

et al. 1990

Artificial Organs

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Neutrophil oxidative metabolism, C3d and β2 microglobulin levels, were assessed in nine consecutive patients undergoing cardiopulmonary bypass surgery with polypropylene hollow fiber oxygenators for open cardiac operations. Generation of oxygen free radicals by neutrophils was measured as luminol‐enhanced chemiluminescence after stimulation with opsonized Zymosan and phorbol myristate acetate. A significant increase in light emission was detected by using both of the chemiluminescence stimulators. Moreover, a remarkable and significant increase in C3d levels was found already at 10 min. Conversely minimal changes in levels of p2 microglobulin were detected during cardiopulmonary bypass surgery. These data suggest that the impact of the patient blood with the foreign surface of cardiopulmonary bypass results in activation of phagocyte cells with increased potential in oxygen consumption. These effects could be partially complement‐mediated.

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Complement activation and neutropenia occurring during cardiopulmonary bypass

Cited by 297 publications

References 16 publications

Pharmacology of Aprotinin and Efficacy During Cardiopulmonary Bypass

Pharmacology of Aprotinin and Efficacy During Cardiopulmonary Bypass

Granulocytes in bronchial lavage fluid after major vascular surgery

Changes in Neutrophil Oxidative Potential in Patients Undergoing Cardiopulmonary Bypass with Polypropylene Hollow Fiber Oxygenators

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