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The Annals of Thoracic Surgery, Vol 56, 847-853, Copyright © 1993 by The Society of Thoracic Surgeons
AM Gillinov, JM Bator, KJ Zehr, JM Redmond, RM Burch, C Ko, JA Winkelstein, RS Stuart, WA Baumgartner and DE Cameron
The neutrophil-mediated tissue injury associated with cardiopulmonary
bypass (CPB) is thought to require the interaction of specific neutrophil
and endothelial adhesion molecules. In this study, the effects of CPB on
the expression of neutrophil CD11b and CD18 (the components of the Mac-1
adhesion molecule) were examined; the effects of membrane versus bubble
oxygenators on the expression of neutrophil CD11b and CD18 were compared;
and the plasma levels of the intercellular adhesion molecule-1 (cICAM-1),
an inducible endothelial adhesion molecule, were measured. In addition, the
time courses of complement activation and neutrophil granule release were
measured to determine their temporal relationship to the expression of the
neutrophil adhesion molecule. Fifteen adult patients underwent procedures
requiring cardiopulmonary bypass; hollow-fiber membrane oxygenators were
used in 8 (group M) and bubble oxygenators were used in 7 (group B). Blood
samples were drawn before, during, and after CPB for determination of the
expression of neutrophil CD11b and CD18 (immunofluorescent flow cytometry),
and the plasma cICAM-1, elastase, lactoferrin (enzyme-linked
immunoabsorbent assay), and plasma C3a (radioimmunoassay) levels. CPB
caused an immediate and sustained increase in the neutrophil CD11b and CD18
expression in both groups; after 60 minutes of CPB, CD11b expression had
increased by 116.9% +/- 19.1% in group B and by 79.3% +/- 8.5% in group M
(p = 0.78). Over the same period, CD18 expression increased by 97.2% +/-
17.9% in group B and by 72.4% +/- 16.8% in group M (p = 0.67).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Neutrophil adhesion molecule expression during cardiopulmonary bypass with bubble and membrane oxygenators
Department of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
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