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Ann Thorac Surg 2005;80:1394-1400
© 2005 The Society of Thoracic Surgeons
a Division of Critical Care, Hospital Universitario "Virgen del Rocío," Sevilla, Spain
b Division of Cardiac Surgery, Hospital Universitario "Virgen del Rocío," Sevilla, Spain
c Division of Hematology, Hospital Universitario "Virgen del Rocío," Sevilla, Spain
Accepted for publication April 14, 2005.
* Address reprint requests to Dr Leal-Noval, Servicio de Cuidados Críticos y Urgencias, Hospital Universitario "Virgen del Rocío" Avda/Manuel Siurot, s/n°, Seville 41013, Spain (Email: sramon{at}cica.es).
BACKGROUND: Activated leukocytes may increase morbidity in cardiac surgery. The objective of this study is to investigate the influence on morbidity of leukocyte-depleting blood filters placed into the arterial line of cardiopulmonary bypass circuits.
METHODS: Simple, blind, prospective, randomized and controlled clinical trial carried out in a cardiac surgery ICU at a university center. We included 159 consecutive low-risk patients (ie, Parsonnet score < 10) undergoing cardiac surgery who were initially stratified in three risk levels according to the Parsonnet score at admission into the hospital (ie, low, < 4; middle, 4 to 7; and high, 8 to 10). Once stratified, all patients were randomized to undergo cardiopulmonary bypass either with a conventional blood filter or with a leukocyte filter (randomization ratio, 2:1). The outcome variable was morbidity. Patients were considered to have a high morbidity if any of the following clinical situations were present (ie, pulmonary dysfunction, cardiac dysfunction, perioperative infections, postoperative hyperthermia, and hyperdynamic states).
RESULTS: The leukocyte filter was used in 52 patients and the conventional filter in 107 patients. The morbidity rate was similar in both groups, but patients with leukocyte filter had a lower incidence of perioperative infections, fever, and hyperdynamic states as compared with patients with the conventional filter.
CONCLUSIONS: Leukocyte filtration in patients undergoing cardiac surgery with extracorporeal perfusion showed no measurable effects on postoperative morbidity. However, although not statistically significant, a decrease was observed in the rates of perioperative infection, fever, and hyperdynamic states.
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