Platelet and neutrophil activation in cardiopulmonary bypass

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Platelet and neutrophil activation in cardiopulmonary bypass

RW Colman
Thrombosis Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania 19140.

My colleagues and I have employed a simulated extracorporeal circuit to help define blood cell changes during clinical cardiopulmonary bypass. Platelet count decreases sharply due to temporary adhesion to the circuit. Platelets degranulate, synthesize and release thromboxane A2, and lose the ability to aggregate with adenosine diphosphate and epinephrine. These changes are also due to the loss of alpha 2- adrenergic and fibrinogen receptors. The neutrophil count decreases to a lesser extent, but neutrophils also are stimulated to secrete lactoferrin and elastase concomitant with activation of plasma kallikrein. Although lidocaine can inhibit the neutrophil activation and prostacyclin can inhibit the platelet stimulation, prostaglandin E1 appears to prevent both neutrophil and platelet alterations.

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				R. Gerrah, A. Elami, A. Stamler, A. Smirnov, and Z. Stoeger Preoperative Aspirin Administration Improves Oxygenation in Patients Undergoing Coronary Artery Bypass Grafting Chest, May 1, 2005; 127(5): 1622 - 1626. [Abstract] [Full Text] [PDF]

				J. Vinten-Johansen Involvement of neutrophils in the pathogenesis of lethal myocardial reperfusion injury Cardiovasc Res, February 15, 2004; 61(3): 481 - 497. [Abstract] [Full Text] [PDF]

				R. Gerrah and U. Izhar Beneficial Effect of Aspirin on Renal Function Post-Cardiopulmonary Bypass Asian Cardiovasc Thorac Ann, December 1, 2003; 11(4): 304 - 308. [Abstract] [Full Text] [PDF]

				J. Noora, A. Lamy, K. M Smith, R. Kent, D. Batt, J. Fedoryshyn, and X. Wang The effect of oxygenator membranes on blood: a comparison of two oxygenators in open-heart surgery Perfusion, September 1, 2003; 18(5): 313 - 320. [Abstract] [PDF]

				F. Patane, A. Verzini, E. Zingarelli, and M. di Summa Simultaneous operation for cardiac disease and lung cancer Interactive CardioVascular and Thoracic Surgery, December 1, 2002; 1(2): 69 - 71. [Abstract] [Full Text] [PDF]

				J. M. Murkin Adverse Central Nervous System Outcomes After Cardiopulmonary Bypass: A Beneficial Effect of Aprotinin? Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 282 - 285. [Abstract] [PDF]

				J. M. Murkin Attenuation of neurologic injury during cardiac surgery Ann. Thorac. Surg., November 1, 2001; 72(5): S1838 - 1844. [Abstract] [Full Text] [PDF]

				T. Scholz, R. Solberg, C. Okkenhaug, V. Videm, M. J Gallimore, O. Mathisen, T. Pedersen, T. E Mollnes, A. Bergan, O. Soreide, et al. Veno-venous bypass in liver transplantation: heparin-coated perfusion circuits reduce the activation of humoral defense systems in an in vitro model Perfusion, July 1, 2001; 16(4): 285 - 292. [Abstract] [PDF]

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				J. M. Murkin Strategies and Techniques for Neuroprotection in Coronary Artery Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 4 - 8. [Abstract] [PDF]

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				A. SERRAF, H. SELLAK, P. HERVÉ, N. BONNET, M. ROBOTIN, H. DETRUIT, B. BAUDET, G.�M. MAZMANIAN, and C. PLANCHE Vascular Endothelium Viability and Function after Total Cardiopulmonary Bypass in Neonatal Piglets Am. J. Respir. Crit. Care Med., February 1, 1999; 159(2): 544 - 551. [Abstract] [Full Text]

				H. J Williams, N. Rebuck, M. J Elliott, and A. Finn Changes in leucocyte counts and soluble intercellular adhesion molecule-1 and E-selectin during cardiopulmonary bypass in children Perfusion, September 1, 1998; 13(5): 322 - 327. [Abstract] [PDF]

				E. Belougne-Malfattie, O. Aguejouf, L. Labrousse, and C. Doutremepuich A Comparison of Heparin and New Anticoagulants for Cardiopulmonary Bypass Surgery Clinical and Applied Thrombosis/Hemostasis, April 1, 1998; 4(2): 118 - 125. [Abstract] [PDF]

				W. J. Dreyer, A. R. Burns, S. C. Phillips, M. L. Lindsey, P. Jackson, and G. L. Kukielka Intercellular Adhesion Molecule-1 Regulation In The Canine Lung After Cardiopulmonary Bypass J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 689 - 693. [Abstract] [Full Text] [PDF]

				M G Macey, D A McCarthy, U H Trivedi, G E Venn, D J Chambers, and K A Brown Neutrophil adhesion molecule expression during cardiopulmonary bypass: a comparative study of roller and centrifugal pumps Perfusion, September 1, 1997; 12(5): 293 - 301. [Abstract] [PDF]

				S. Bannan, A. Danby, D. Cowan, S. Ashraf, and P. G. Martin Low Heparinization With Heparin-Bonded Bypass Circuits: Is It a Safe Strategy? Ann. Thorac. Surg., March 1, 1997; 63(3): 663 - 668. [Abstract] [Full Text]

ARTICLES

Platelet and neutrophil activation in cardiopulmonary bypass

				K. Holada, J. Simak, V. Kucera, L. Roznova, and T. Eckschlager Platelet membrane receptors during short cardiopulmonary bypass - a flow cytometric study Perfusion, September 1, 1996; 11(5): 401 - 406. [Abstract] [PDF]

				V. Rao, T. R. J. Todd, R. D. Weisel, M. Komeda, G. Cohen, J. S. Ikonomidis, and G. T. Christakis Results of Combined Pulmonary Resection and Cardiac Operation Ann. Thorac. Surg., August 1, 1996; 62(2): 342 - 346. [Abstract] [Full Text]

				R. L. Korn, C. A. Fisher, E. R. Livingston, N. Stenach, S. J. Fishman, V. Jeevanandam, and V. P. Addonizio THE EFFECTS OF CARMEDA BIOACTIVE SURFACE ON HUMAN BLOOD COMPONENTS DURING SIMULATED EXTRACORPOREAL CIRCULATION J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1073 - 1084. [Abstract] [Full Text]

				O. Moen, E. Fosse, J. Braten, C. Andersson, K. Hogasen, T. Mollnes, P. Venge, and P. Kierulf Differences in blood activation related to roller/centrifugal pumps and heparin coated/uncoated surfaces in a cardiopulmonary bypass model circuit Perfusion, March 1, 1996; 11(2): 113 - 123. [Abstract] [PDF]

				A. Finn, B. P. Morgan, N. Rebuck, N. Klein, C. A. Rogers, M. Hibbs, M. Elliott, D. F. Shore, T. W. Evans, S. Strobel, et al. EFFECTS OF INHIBITION OF COMPLEMENT ACTIVATION USING RECOMBINANT SOLUBLE COMPLEMENT RECEPTOR 1 ON NEUTROPHIL CD11B/CD18 AND L-SELECTIN EXPRESSION AND RELEASE OF INTERLEUKIN-8 AND ELASTASE IN SIMULATED CARDIOPULMONARY BYPASS J. Thorac. Cardiovasc. Surg., February 1, 1996; 111(2): 451 - 459. [Abstract] [Full Text]

				D. F Larson, M. Bowers, and H W. Schechner Neutrophil activation during cardiopulmonary bypass in paediatric and adult patients Perfusion, January 1, 1996; 11(1): 21 - 27. [Abstract] [PDF]

				G. A Ortolano Potential for reduction in morbidity and cost with total leucocyte control for cardiac surgery Perfusion, September 1, 1995; 10(5): 283 - 290. [Abstract] [PDF]

				D. Gadaleta, A. L. Fahey, M. Verma, W. Ko, K. H. Kreiger, O. W. Isom, and J. M. Davis Neutrophil leukotriene generation increases after cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 642 - 647. [Abstract] [Full Text]

				J R. Upp Jr, P. E Bush, and J. B Zwischenberger Complications of neonatal extracorporeal membrane oxygenation Perfusion, July 1, 1994; 9(4): 241 - 256. [PDF]

				D. A Palanzo, N. J Manley, R. M Montesano, G. L Yeisley, and D. Gordon Clinical evaluation of the LeukoGuard (LG-6) arterial line filter for routine open-heart surgery Perfusion, November 1, 1993; 8(6): 489 - 496. [Abstract] [PDF]