The Clinical Study Of Effects Of Leukocyte Filtration On Residual Pump Blood After Cardiopulmonary Bypass And Infusion Residual Pump Blood After CPB Processed By Leukocyte Filter

Objective1.To evaluate the effects of leukocyte filtration(LF)on blood components and cytokines of residual pump blood after cardiopulmonary bypass(CPB).2.To study the effects of leukocyte filter processed residual pump blood infusion on the systemic inflammatory response and patients recovery.MethodsForty patients who underwent selective cardiac surgery with CPB in Fu Wai Hospital from 2013 year were included in this study.Patients requiring heterogenous blood transfusion were excluded.All the patients were randomly divided into an experimental group and a control group.In the experimental group,patients received residual pump blood transfusion which had been processed with LF and stored in sterile blood collection bags.In the control group,patients received residual pump blood transfusion which was stored in sterile blood collection bags without LF process after CPB.Blood samples were taken before CPB(T1),residual pump blood(T2),at the end of CPB(T2'),at 4 hours after CPB(T3),and 6 hours after the residual blood infusion finished(T3')to examine blood components((white blood cell(WBC),neutrophil(NEU),red blood cell(RBC),hemoglobin(Hb),hematocrit(HCT),platelet(Plt))and concentrations of interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-a(TNF-a),colloid osmotic pressure(COP),free hemoglobin(FHb).Patient's temperature,leukocyte counts before CPB(T1),at the end of CPB(T2'),6 hours after the residual blood infusion finished(T3')and next morning after operation(T4),and mechanical ventelation time at were recorded.Results1.There were no statistical difference in gender,age,weight,CPB time,residual pump blood and clamping time between the 2 groups(P>0.05).2.WBC and NEU count of the experimental group were significantly lower than those of the control group at T2 and T3(P<0.05).There was no statistical difference in RBC,Hb,HCT and FHb at respective time points between the 2 groups(P>0.05).There was no statistical difference in plasma IL-6,IL-10 and TNF-a concentrations at different time points within either group(P>0.05)or at respective time points between the 2 groups(P>0.05).3.WBC count of the residual pump blood which had been processed with LF before and after filtration in experimental group(T2)was(4.78±0.62)×10~9/L vs.(0.10±0.13)×10~9/L,(P<0.001).6h after the residual pump blood infusion(T3'),WBC count of the experimental group was higher than that of the control group(12.48±1.10)×10~9/L vs.(9.10±0.05)×10~9/L,(P<0.05).First morning after operation,WBC(T4)count of the experimental group is higher than that of the control group(14.71 ±0.83)×10~9vs.(11.66±0.57)×10~9,(p<0.01).There was no difference in intubation time between the two groups,the experimental group(17.8±1.5)vs.the control group(15.6±1.01)(P>0.05).There was no statistical difference in other outcomes between the two groups.Conclusion1.LF could reduce white blood cell count and neutrophil count of residual pump blood,but does not significantly change other blood components and plasma concentrations of IL-6,IL-10 or TNF-a after CPB.2.There was no evidences demonstrate that infusion residual pump blood after CPB processed with leucocyte filter could inhibit systemic inflammatory response in our study.The counts of leucocyte was increased significantly in experimental group at the following time points:6 hours after the residual blood infusion and first morning after operation.