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Ann Thorac Surg 1992;54:725-731
© 1992 The Society of Thoracic Surgeons

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Articles

Time for new concepts about measurement of complement activation by cardiopulmonary bypass?

^a Institute for Experimental Medical Research and Department of Surgery, Ullevaal Hospital, Oslo, Norway
^b Institute of Immunology and Rheumatology, The National Hospital, Oslo, Norway

Accepted for publication February 19, 1992.

^_* Address reprint requests to Dr Videm, Institute for Experimental Medical Research, Ullevaal Hospital, N-0407 Oslo 4, Norway.

	Abstract

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Fifty-one patients admitted for routine coronary bypass operations were randomized to cardiopulmonary bypass with a membrane oxygenator (Capiox) or a bubbler (Polystan or William Harvey). Complement activation was measured using enzyme immunoassays for concentrations of C3 activation products and the terminal complement complex. From 5.8 to 8.1 arbitrary units (AU)/mL (medians), the plasma concentrations of C3 activation products increased by 119.9 AU/mL (Capiox), 124.6 AU/mL (Polystan), and 79.5 AU/mL (William Harvey) to a peak at closure of the sternum (not significant when related to baseline concentrations). The increase in C3 activation products and baseline C3 activation were linearly correlated (R ² = 0.30; p < 0.0001). From 5.5 to 6.1 AU/mL, the plasma terminal complement complex concentrations increased by 45.2 AU/mL (Capiox), 15.4 AU/mL (Polystan), and 17.4 AU/mL (William Harvey) to a peak before termination of cardiopulmonary bypass. Maximal terminal (C5–C9) activation was significantly higher in the membrane oxygenator group (p < 0.0001) and showed no relationship to C3 activation. Measurement of C3 activation only gives no information about C5–C9 activation. At present, terminal complement complex quantitation is probably the best index of C5–C9 activation during cardiopulmonary bypass.

	Footnotes

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This study was supported by Anders Jahre's Fund for the Promotion of Science, The Norwegian Council on Cardiovascular Research, the Nordic Insulin Foundation, and the Norwegian Research Council for Science and the Humanities.

	References

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