The Effect of Leukocyte Filtration on Blood Quality and Its Observation

2021 ◽  
Keyword(s):  
Leukocyte Filtration

Leukocyte Filtration Removes Infectious Particulate Debris but Not Free Virus Derived from Experimentally Lysed HIV-Infected Cells

Vox Sanguinis ◽  
1991 ◽  
Vol 60 (4) ◽  
pp. 214-218
Author(s):  
Bhupat Rawal ◽  
T.S. Benedict Yen ◽  
Girish N. Vyas ◽  
Michael Busch
Keyword(s):  
Free Virus ◽  
Infected Cells ◽  
Particulate Debris ◽  
Leukocyte Filtration

Leukocyte Filtration Ameliorates the Inflammatory Response in Patients With Mild to Moderate Lung Dysfunction

2011 ◽  
Vol 92 (1) ◽  
pp. 111-121 ◽  
Author(s):  
Francesco Onorati ◽  
Francesco Santini ◽  
Giovanni Mariscalco ◽  
Paolo Bertolini ◽  
Andrea Sala ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Lung Dysfunction ◽  
Leukocyte Filtration

Biocompatibility of Leukocyte Removal Filters during Leukocyte Filtration of Cardiopulmonary Bypass Perfusate

2008 ◽  
Vol 17 (7) ◽  
pp. 660-665 ◽  
Author(s):  
Y.J. Gu ◽  
R. Obster ◽  
J. Haan ◽  
R.C.G. Gallandat Huet ◽  
A. Eijgelaar ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Leukocyte Filtration

scholarly journals Leukocyte filtration improves brain protection after a prolonged period of hypothermic circulatory arrest: A study in a chronic porcine model

2000 ◽  
Vol 120 (6) ◽  
pp. 1131-1140 ◽  
Author(s):  
Jussi Rimpiläinen ◽  
Matti Pokela ◽  
Kai Kiviluoma ◽  
Vesa Anttila ◽  
Vilho Vainionpää ◽  
...  
Keyword(s):  
Porcine Model ◽  
Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Brain Protection ◽  
Leukocyte Filtration

Timing of leukocyte filtration during cardiopulmonary bypass

Perfusion ◽  
2001 ◽  
Vol 16 (1_suppl) ◽  
pp. 31-37 ◽  
Author(s):  
G Matheis ◽  
M Scholz ◽  
A Simon ◽  
D Henrich ◽  
G Wimmer-Greinecker ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Leukocyte Filtration

Strategic leukocyte depletion reduces pulmonary microvascular pressure and improves pulmonary status post-cardiopulmonary bypass

Perfusion ◽  
2003 ◽  
Vol 18 (1_suppl) ◽  
pp. 23-31 ◽  
Author(s):  
A H Olivencia-Yurvati ◽  
C A Ferrara ◽  
N Tierney ◽  
N Wallace ◽  
R T Mallet
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Function ◽  
Control Group ◽  
Study Group ◽  
Pulmonary Dysfunction ◽  
Shunt Fraction ◽  
Pulmonary Shunt ◽  
Leukocyte Depletion ◽  
Pulmonary Capillary ◽  
Leukocyte Filtration

Cardiopulmonary bypass (CPB) precipitates inflammation that causes marked pulmonary dysfunction. Leukocyte filtration has been proposed to reduce these deleterious effects. Other studies show an improvement with aprotinin. We proposed that a combination of these two therapies would synergistically improve pulmonary outcomes. Two hundred and twenty-five patients participated in a randomized prospective study comparing pulmonary microvascular function and pulmonary shunt fraction postcoronary artery bypass grafting (CABG). The study group underwent leukocyte depletion with aprotinin during the procedure. Pulmonary microvascular function was assessed by pulmonary microvascular pressure (PMVP), a measure of pulmonary capillary edema, and pulmonary function was evaluated by comparing pulmonary shunt fractions. Elevated PMVP and increased pulmonary shunting compromise pulmonary performance. The leukocyte-depleted group had significantly reduced PMVP and pulmonary shunt fraction for at least the first 24 hours postbypass. The combination of strategic leukocyte filtration and aprotinin therapy can effectively reduce postoperative decline in pulmonary function. Cardiopulmonary bypass precipitates a variety of inflammatory effects that can cause marked pulmonary dysfunction to the point of respiratory failure, necessitating prolonged mechanical ventilation. Leukocyte filtration has been investigated previously and appears to be beneficial in improving pulmonary outcome by preventing direct neutrophil-induced inflammatory injury. Recent studies of leukocyte reduction profiles suggest that leukoreduction via leukofiltration is short lived with filter saturation occurring 30 - 45 minutes after onset of filtration. This phenomenon may explain the limited utility observed with higher risk patients. These patients typically require longer pump runs, so leukocyte reduction capability is suboptimal at the time of pulmonary vascular reperfusion. To more effectively protect the lung from reperfusion injury, leukocyte filtration can be delayed so that reduction of activated neutrophils is maximal at the time of pulmonary vascular reperfusion. It is, thus, conceivable that a timely use of arterial line leukoreducing filters may improve, more substantially, pulmonary function postbypass. Two hundred and twenty-five isolated coronary revascularization patients participated in this prospective, randomized trial. The patients received moderately hypothermic CBP alone (control group: n = 110) or combined with leukocyte depletion, initiated 30 minutes before crossclamp release, with filters placed in the bypass circuit (study group: n = 115). All patients also received full Hammersmith aprotinin dosing during the operation. Pulmonary microvascular pressures were lower in the study group at three hours postbypass, and continued to fall until 24 hours postbypass. In contrast, the control group measured a rise in PMVP and a continued plateau throughout 24 hours postbypass (p B /0.028). The calculated pulmonary shunt fraction also was reduced significantly throughout the study interval, with the greatest reduction occurring approximately three to six hours post-CPB (p B /0.002). Shunt fractions eventually converged at 24 hours postbypass. Outcome measures included hospital charges and length of stay, which were also markedly reduced in the treatment group. Increasing PMVPs are a direct reflection of pulmonary capillary edema, which, in conjunction with increased pulmonary shunt ratio, lead to an overall worsening of pulmonary function. Intraoperative strategic leukocyte filtration combined with aprotinin treatment improves post-CPB lung performance by reducing significantly the reperfusion inflammatory response and its sequelae. These benefits are manifested by reductions in ventilator times, hospital stay and patient morbidity.

Leukocyte filtration and miniature perfusion during arrested heart CABG on a Jehovah’s Witness patient

Perfusion ◽  
2004 ◽  
Vol 19 (6) ◽  
pp. 375-379 ◽  
Author(s):  
Steven W Sutton ◽  
Michael A Duncan ◽  
Virginia A Chase ◽  
Edson H Cheung ◽  
B L Hamman
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Surface Area ◽  
Centrifugal Pump ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Autologous Blood ◽  
Blood Products ◽  
Triple Vessel Disease ◽  
Leukocyte Filtration

Bloodless surgery and a reduction in the use of allogeneic blood products has long been the standard of care in medicine. Many individuals in our communities have demanded this form of surgical treatment for personal and religious reasons. On 6 December 2002, a 72-year-old male patient was admitted to our institution as a critical air flight transfer. The patient’s height was 190.5 cm and weight was 59.3 kg (body surface area 1.83 m2). His preliminary diagnosis was chest pain with myocardial infarction as evidenced by elevated blood cardiac isoenzymes. His principle diagnosis was subendocardial infarction with paroxysmal ventricular tachycardia. Cardiac catheterization was performed and demonstrated severe triple vessel disease with an ejection fraction of 30%. He was evaluated and accepted as a candidate for coronary artery bypass grafting. Multidisciplinary consultation concluded that a safe and effective method of perioperative treatment would involve the use of arrested heart support with cold blood cardioplegia using a low prime miniature perfusion circuit as no blood products would be considered for use. Additionally, the combined modalities of perfusion interventions to minimize hemodilution consisted of intraoperative autologous blood collection totaling 500 mL and rapid autologous priming of the miniature perfusion circuit. The miniature perfusion system was a low prime Cardiovention (Santa Clara, CA) CORx device which includes a hollow-fiber oxygenator and integral centrifugal pump with a surface area of 1.2 m2. This system also incorporates an air sensing solenoid which triggers rapid air evacuation in a bolus range of 1 mL or greater. Kinetic venous drainage is another feature of this device as the centrifugal pump is integrated into the oxygenator. We believed that a miniature extracorporeal circuit would enhance the desired clinical outcome as opposed to the risk of: (1) off-pump coronary artery bypass (OPCAB) approach and the concern of emergent transition to an on-pump procedure and (2) use of larger surface area with conventional systems that impose a greater hemodilutional effect. Leukocyte filtration was employed as the patient had a significant past medical history of chronic obstructive pulmonary disease. We herein report our clinical experience with this method of treatment on a patient who refused the use of blood products in his surgical treatment. It is our belief that the multiple modalities utilized in combination during this procedure resulted in positive clinical outcomes as demonstrated by an intubation time of 8 hours 35 min with a discharge on the fifth postoperative day.

TIMING OF LEUKOCYTE FILTRATION DURING CARDIAC SURGERY

1999 ◽  
Vol 88 (Supplement) ◽  
pp. 15SCA
Author(s):  
AJ de Vries ◽  
YJ Gu ◽  
W van Oeveren
Keyword(s):  
Cardiac Surgery ◽  
Leukocyte Filtration
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