Leukocyte depletion during cardiac surgery with extracorporeal circulation in high risk patients

Bakhtiary, Farhad; Moritz, Anton; Kleine, Peter; Dzemali, Omer; Simon, A; Ackermann, Hanns; Martens, Sven

doi:10.1007/s00011-008-8031-8

Cited by 9 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to local effects of cell adhesion / activation systemic clinical consequences that have been directly related to leukocyte activation include infection, myocardial infarction as well as organ injury and failure [80,118]. Leukocyte removal filters have been introduced in cardiopulmonary bypass (CPB) [119] yet released inflammatory mediators from the trapped cells could contribute to the inflammatory response [120].…”

Section: Follow-on Commentsmentioning

confidence: 99%

The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells

et al. 2019

View full text Add to dashboard Cite

Section: Follow-on Commentsmentioning

confidence: 99%

The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells

et al. 2019

View full text Add to dashboard Cite

“…Bakhtiary et al discovered a positive correlation between the level of leukocytes and inflammation. Their research showed that the depletion of leukocytes caused the reduction of inflammatory response [ 21 ]. Based on these results and our statistical data, we speculated that the percentage of neutrophil and WBC may be used to predict AGC.…”

Section: Discussionmentioning

confidence: 99%

Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute purulent cholecystitis

Chen

Huang

et al. 2022

BMC Gastroenterol

View full text Add to dashboard Cite

Background Preoperative prediction of severe cholecystitis (SC), including acute gangrenous cholecystitis (AGC) and acute purulent cholecystitis (APC), as opposed to acute exacerbation of chronic cholecystitis (ACC), is of great significance, as SC is associated with high mortality rate. Methods In this study, we retrospectively investigated medical records of 114 cholecystitis patients, treated in Shanghai No. 6 People’s Hospital from February 2009 to July 2020. Gallbladder wall thickness (GBWT), indexes of blood routine examination, including white blood cell (WBC), alkaline phosphatase (ALP), the percentage of neutrophil, alanine transaminase (ALT), aspartate aminotransferase (AST), fibrinogen (FIB), gamma-glutamyl transferase, prothrombin time and total bilirubin were evaluated. One-way analysis of variance (ANOVA) was used to evaluate significant differences between a certain kind of SC and ACC to select a prediction index for each kind of SC. Receiver operating characteristic (ROC) curve analysis was conducted to identify the prediction effectiveness of these indexes and their optimal cut-off values. Results Higher WBC and lower ALP were associated with AGC diagnosis (P < 0.05). Higher percentage of neutrophils was indicative of APC and AGC, while higher GBWT was significantly associated with APC diagnosis (P < 0.05) The optimal cut-off values for these indexes were established at 11.1*109/L (OR: 5.333, 95% CI 2.576–10.68, P < 0.0001, sensitivity: 72.73%, specificity: 66.67%), 79.75% (OR: 5.735, 95% CI 2.749–12.05, P < 0.0001, sensitivity: 77.92%, specificity: 61.9%) and 5.5 mm (OR: 22, 95% CI 4.757–83.42, P < 0.0001, sensitivity: 78.57%, specificity: 85.71%), respectively. Conclusion We established a predictive model for the differentiations of APC and AGC from ACC using clinical indexes, such as GBWT, the percentage of neutrophil and WBC, and determined cut-off values for these indexes based on ROC curves. Index values exceeding these cut-off values will allow to diagnose patients as APC and AGC, as opposed to a diagnosis of ACC.

show abstract

“…They concluded that leukocyte depletion was not advantageous from clinical and biomedical end points in the patient group studied. 27 The use of cell-saving devices in the setting of CPB is still controversial. 28 Two major prospective randomized double-blind trials assessing the use of a cell-saving device yielded different results.…”

Section: Avoiding Stroke By Modifying the Surgical Approachmentioning

confidence: 99%

Avoiding Stroke During Cardiac Surgery

Kellermann

Jungwirth

2010

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

The life saving benefits of cardiac surgery are frequently accompanied by negative side effects such as stroke, that occurs with an incidence of 2%-13% dependent to type of surgery. The etiology is most likely multifactorial with embolic events considered as main contributor. Although stroke presents a common complication, no guidelines for any routine use of pharmacological substances or non-pharmacological strategies exist to date. Non-pharmacological strategies include monitoring of brain oxygenation and perfusion with devices such as near infrared spectroscopy and Transcranial Doppler help. Epiaortic and transesophageal echocardiography visualize aorta pathology, enabling the surgeon to sidestep atheromatous segments. Additionally can the use of specially designed aortic cannulae and filters help to reduce embolization. Brain perfusion can be improved by using antero- or retrograde cerebral perfusion during deep hypothermic circulatory arrest, by tightly monitoring mean arterial blood pressure and hemodilution. Controlling perioperative temperature and glucose levels may additionally help to ameliorate secondary damage. Many pharmacological compounds have been shown to be neuroprotective in preclinical models, but clinical studies failed to confirm these results so far. Remacemide, an NMDA-receptor-antagonist showed a significant drug-based neuroprotection during cardiac surgery. Other substances currently assessed in clinical trials whose results are still pending are acadesine, an adenosine-regulating substance, the free radical scavenger edaravone and the local anesthetic lidocaine. Stroke remains as significant complication after cardiac surgery. Non-pharmacological strategies allow perioperative caregivers to detect injurious events and to ameliorate stroke and its sequelae. Considering the multi-factorial etiology though, stroke prevention will likely have to be addressed with an individualistic combination of different strategies and substances.

show abstract

Leukocyte depletion during cardiac surgery with extracorporeal circulation in high risk patients

Abstract: Interestingly, the activation of neutrophils was more pronounced in the LF group. The use of a leucocyte depleting filter was not advantageous for this patient cohort for clinical or biomedical endpoints.

Cited by 9 publications

References 16 publications

The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells

The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells

Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute purulent cholecystitis

Avoiding Stroke During Cardiac Surgery

Contact Info

Product

Resources

About