Temporary leukocyte depletion reduces ventricular dysfunction during prolonged postischemic reperfusion

Wilson, Ian C.; Gardner, Timothy J.; DiNatale, Joseph; Gillinov, A. Marc; Curtis, William E.; Cameron, Duke E.

doi:10.1016/s0022-5223(19)34033-4

Cited by 49 publications

(22 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Activated leukocytes may also release inflammatory mediators, and generate oxidizing agents and toxic substances . The removal of activated leukocytes by filtration has been used as an anti‐inflammatory strategy . Filtration was performed at different sites.…”

Section: Strategies To Decrease Systemic Inflammation Related To Cpbmentioning

confidence: 99%

Minimizing Systemic Inflammation During Cardiopulmonary Bypass in the Pediatric Population

Durandy

2013

Artificial Organs

View full text Add to dashboard Cite

Cardiopulmonary bypass (CPB) is known to cause a systemic inflammatory response. Inflammation includes several cascade activations: complement, cytokine, and coagulation. The early phase is triggered by blood contact with the synthetic bypass circuit and the late phase by ischemia-reperfusion and endotoxemia. Systemic inflammatory response syndrome (SIRS) is constant following cardiac surgery; however, a compensatory anti-inflammatory response is also constant and the clinical manifestations (varying from uncomplicated SIRS to shock and multiple organ dysfunction) depend on the balance between the two responses. When overexpressed, the inflammatory response may significantly increase a patient's risk. Minimization of systemic inflammation is a major concern and several strategies aiming to inhibit the inflammatory response are described. None of them is satisfactory, but the "control" of the inflammatory response extent is likely to require a multimodal approach. This review aims to describe the strategies proposed to reduce CPB-related systemic inflammation.

show abstract

Section: Strategies To Decrease Systemic Inflammation Related To Cpbmentioning

confidence: 99%

Minimizing Systemic Inflammation During Cardiopulmonary Bypass in the Pediatric Population

Durandy

2013

Artificial Organs

View full text Add to dashboard Cite

show abstract

“…Numerous experimental and clinical studies now support the beneficial effects of leukocyte depletion. 22,26,34,35,[41][42][43][44][45] In fact, even partially removing white cells has been found to prevent oxygen radical damage and subsequent lung injury in cyanotic and pulmonary hypertensive infants. 34 Therefore, despite the shortcomings of this acute hypoxic model, it seems likely that the beneficial effects observed in this study will be seen if normoxia and leukodepletion are used clinically.…”

Section: Systemic Leukodepletion In Pediatric Heart Surgery 21mentioning

confidence: 99%

Hypoxia, reoxygenation and the role of systemic leukodepletion in pediatric heart surgery

Allen

Ilbawi

2001

Perfusion

View full text Add to dashboard Cite

As cardiopulmonary bypass (CPB) in infants and neonates is becoming more frequent, the technical performance of these operations for congenital heart disease has made significant progress. However, little research has been carried out into the conduct of CBP in producing myocardial and pulmonary dysfunction. Postoperative organ dysfunction is a problem, particularly for cyanotic infants. This paper examines the experimental and clinical experience of injury brought about by abrupt reoxygenation of the hypoxic, or cyanotic, heart. The modalities of gradual reoxygenation and leukodepletion in limiting this injury are examined, leading to the conclusion that injury can be reduced and possibly ameliorated by changes in intraoperative management during CBP in children with cyanotic disease.

show abstract

“…The use of different contractile performance indexes and assessment techniques could contribute to these conflicting findings. For instance, various studies report contractile performance indexes, including peak systolic pressure (9,10,12,15,20,23,35,36), developed pressure (1,13,15,17,23,28,30,32,36), systolic pressure-rate product (10,20), and maximum rate of systolic pressure increase per unit time (ϩdP/dt max ) (1,8,10,12,13,17,23,36), but rarely examine more than one or two of these indexes simultaneously. Interestingly, studies (23,36) that examined two indexes found that peak systolic pressure had two-to threefold greater postischemic functional recovery than either developed pressure or ϩdP/dt max .…”

mentioning

confidence: 99%

Postischemic functional recovery in immature hearts is influenced by performance index and assessment technique

Torrance

Wittnich²

2001

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

In the in vivo immature heart, conflicting results are reported for postischemic functional recovery. This study determines whether interpretations of functional recovery are influenced by the contractile performance index (systolic pressure, developed pressure, and maximum rate of systolic pressure increase per unit time) reported or the assessment technique (isovolumetric and variable-volume) utilized. In neonatal pigs (n = 6) on cardiopulmonary bypass, each performance index was examined using both assessment techniques before myocardial ischemia and at 15, 30, and 60 min of reperfusion. With the use of the isovolumetric technique, all performance indexes had significantly different recovery. With the use of the variable-volume assessment technique, recovery of systolic pressure was significantly better than the other indexes. When recovery was compared between the two assessment techniques, systolic pressure recovered significantly better when assessed using the variable-volume technique. For each performance index, the correlation between isovolumetric and variable-volume techniques was positive before ischemia but negative during reperfusion, suggesting that the assessment techniques identified conflicting postischemic contractile performances. Thus both the contractile performance index reported and the assessment technique employed are ultimately important in interpreting postischemic functional recovery in the immature heart.

show abstract

Temporary leukocyte depletion reduces ventricular dysfunction during prolonged postischemic reperfusion

Cited by 49 publications

References 7 publications

Minimizing Systemic Inflammation During Cardiopulmonary Bypass in the Pediatric Population

Minimizing Systemic Inflammation During Cardiopulmonary Bypass in the Pediatric Population

Hypoxia, reoxygenation and the role of systemic leukodepletion in pediatric heart surgery

Postischemic functional recovery in immature hearts is influenced by performance index and assessment technique

Contact Info

Product

Resources

About