A Study on Effect to Complement Activation and Pulmonary Leukostasis During Cardiopulmonary bypass: Comparison of Bubble Oxygenator and Membrane Oxygenator

체외순환이 보체활성화화 백혈구의 폐내 정체에 미치는 영향에 관한 연구

  • Published : 1995.07.01

Abstract

From December 1993 to April 1994, to investigate complement activation and pulmonary leukostasis, thirty adult patients were studied during cardiopulmonary bypass[CPB for cardiac surgery in Department of Cardiovascular & Thoracic Surgery, Pusan Paik Hospital, Inje University. Total patients were divided into group I and II according to the purpose of study ; Group I was 15 patients undergoing CPB with bubble oxygenator, Group II was 15 patients undergoing CPB with membrane oxygenator. The results of study were summarized as follows.1. The decrease of C3 and C4 levels were observed within few minutes of beginning of CPB in all patients[P<0.05 , and this decrease was proved to be due to complement activation, not by the influence of hemodilution.2. In the correlation between the change of C3 and C4, group I showed linear correlation each other suggesting complement activation occurred through the classical pathway, group II showed a correlation at only partial sampling times suggesting complement activation via both classical and alternative pathway, however there was no significant statistical difference at the change of C3 and C4 concentrations in two groups[P>0.05 .3. After switching to partial CPB, a few difference between right atrial and left atrial WBC count was observed, but statistically not significant and median cell count difference between group I and II was not significant, too [P>0.05 . With the above result, we concluded that CPB itself contributes to the activation of complement system, but bubble oxygenator does not activate always complement system more than membrane oxygenator.

Keywords

References

  1. Surgery v.71 Changes in serum complement and immunoglobulins following cardiopulmonary bypass Parker,D.J.;Karp,R.B.;Cantrell,J.W.(et al.)
  2. J. Thorac Cardiovasc Surg v.86 Complement and the damaging effects of cardiopulmonary bypass Kirklin,J.K.;Westaby,S.;Blackstone,E.H.(et al.)
  3. J Clin Invest v.60 Complement (C5a)-induced granulocyte aggregation in Vitro-A possible mechanism of complement-mediated leukostasis and leukopenia Craddock,P.R.;Hammerschmidt,D.E.;White,J.G.(et al.)
  4. N Engl J Med v.304 Complement activation during cardipulmonary bypass Chenoweth,D.E.;Cooper,S.W.;Hugli,T.E.(et al.)
  5. Blood v.51 Effect of intravascular complement activation on granulocyte adhesiveness and distribution O'Flaherty,J.T.;Craddock,P.R.;Jacob,H.S.
  6. N Engl J Med v.302 Complement-induced granulocyte aggregation Craddock P.R.;Hammerschmidt,D.E.;Moldow,C.F.
  7. The Lancet v.1 Association of complement activation and elevated plasma-C5a with adult respiratory distress syndrome Hammerschmidt,D.E.;Weaver,L.J.;Hudson,L.D.(et al.)
  8. Circulation v.74 no.pt 2 Oxygen free radical generation during cardiopulmonary bypass Cavarocchi,N.C.;England,M.D.;Schaff,H.V.(et al.)
  9. J. Clin Invest v.61 Oxygen radicals mediate endothelial cell damage by complement -stimulated granulocytes Sacks,T.;Moldow,C.F.;Craddock,P.R.(et al.)
  10. J. Thorac Cardiovasc Surg v.91 Complement activation during cardiopulmonary bypass Cavarocchi,N.C.;Pluth,J.R.;Schaff,M.V.(et al.)
  11. Ann Thorac Surg v.46 Complement activation in cardiopulmonary bypass, with special reference to anaphylatoxin production in membrane and bubble oxygenators Tamiya,T.;Yamasaki,M.;Maeo,Y.(et al.)
  12. Ann Thorac Surg v.37 Complement (C3,C4) consumption in cardiopulmonary bypass, cardioplegia, and protamine administration Chiu,R.C.J.;Samson,R.
  13. Perfusion v.1 Complement consumption during cardiopumonary bypass Mickleborough,L.;Aronld,G.;Chiu,R.C.J.
  14. N Engl J Med v.296 Complement and leukocyte -mediated pulmonary dysfunction in hemodialysis Carddock,P.R.;Fehr,J.;Brigham,K.L.(et al.)
  15. J. Thorac Cardiovasc Surg v.89 Deleterious effects of cardiopulmonary bapass Oeveren,W.V.;Kasatchkine,M.D.;Maillet F.(et al.)
  16. J. Thorac Cardiovasc Surg v.103 Significance of concentrated red cell and albumin priming method with particular reference to anaphylatoxin generation Tamiya,T.;Maeo,Y.;Okada,T.(et al.)
  17. N Engl Med v.318 Deposition of terminal C5b-9 complement complex on erythrocytes during cardiopulmonary bypass Salama,A.;Hugo,F.;Heinrich,D.(et al.)
  18. Surgery v.3 Evidence for complement activation by protamine-heparin interaction after cardiopulmonary bypass Cavarocchi,N.C.;Schaff,H.V.;Orszulak,T.A.(et al.)
  19. J Thorac Cardiovasc Surg v.91 Increased production of peroxidation products associated with cardiac operation : Evidence for free radical production Royston,D.;Fleming,J.S.;Desai,J.B.(et al.)
  20. 대흉외지 v.19 개심술 후 혈장단백 및 보체 (C3,C4)의 변화상 추적 남충희;조영철;고정관(등)
  21. Anesthesia v.37 Cardiopulmonary bypass and complement activation: involvement of classical and alternative pathways Jones,H.M.;Matthews,N.;Vaughan,R.S.(et al.)
  22. 대흉외지 v.21 체외순환후 혈청내 Immunoglobulin과 보체의 변화상 추적 이철주;정상조;진성훈(등)