Effects of Leukocyte Depleted Priming Solution on Cardiopulmonary Edema by Extracorporeal Circulation

Kim, Si Hoon; Kim, Young Du; Jin, Ung; Jo, Keon Hyun

Abstract

BACKGROUND: Extracorporeal circulation using pump-oxygenator is an inevitable process to keep vital sign during cardiac arrest for open heart surgery. However, the diversion of blood through nonendothelialized channels appears to stimulate inflammatory response, and leukocyte activation may lead to cardiopulmonary edema. Our study evaluated the effect of leukocyte-induced cardiopulmonary edema using three different pump-oxygenator priming solutions; non-hemic crystalloid solution ; leukocyte-depleted homologous blood; non leukocyte-depleted homologous blood in priming solutions. MATERIAL AND METHOD: Each different priming solution was used on five dogs, and the effect of leukocyte-induced cardiopulmonary edema during cardiopulmonary bypass(CPB) was evaluated. For each dog after 2 hours of exracorporeal circulation and another 4 hours of post-pump period, the dog was sacrificed and its heart and lung tissues were obtained for measuring Wet/Dry ratio. Arterial O2 partial pressure(PaO2) and CO2 partial pressure(PaCO2) were checked. For the evaluation of ventilatory function, CO2 partial pressure difference between arterial blood (PaCO2) and exhaled air(EtCO2) was measured. RESULT: 1. No significant difference was seen in arterial PaO2 and PaCO2 among groups. 2. Ventilatory function evaluated by PaCO2 and EtCO2 showed no significant difference between non-hemic and blood-mixed priming solution (P<0.05). 3. Cardiac and lung Wet/Dry ratios were remarkedly lower in the leukocyte- depleted group. There was no significant difference between the non-hemic and blood-mixed groups.
CONCLUSION
Based upon this result, we concluded that the leukocyte depletion from homologous blood of CPB priming solution has a beneficial effect in reducing cardiopulmonary edema compared with non leukocyte-depleted or crystalloid priming solutions.