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• W2027037358 abstract "<h3>Background</h3> Chronic obstructive pulmonary disease is a risk factor for postoperative lung injury. Contradictory results have been published about leukocyte filtration (LF) because of the heterogeneity of patients and interventions, type of LF, and comorbidities. <h3>Methods</h3> Sixty patients with mild moderate chronic obstructive pulmonary disease (forced expiratory volume in 1 second 40% to 80%) undergoing aortic valve surgery were randomly assigned to receive systemic arterial and cardioplegic LF during cardiopulmonary bypass (group L, 30 patients) or standard cardiopulmonary bypass (group S). Perioperative interleukin-6, interleukin-8, and tumor necrosis factor-alpha were sampled at different time points. The PaO₂/inspired oxygen fraction (FiO₂) and alveoloarterial oxygen gradient (AaDO₂) were measured preoperatively, at intensive care unit arrival, and at 24, 48, and 72 hours postoperatively; lung compliance was measured after intubation, at intensive care unit arrival, and at 4 and 8 hours postoperatively; and radiographic lung injury score was determined preoperatively and at 24, 48 and 72 hours. Length of intubation, intensive care unit stay, hospital stay, need for noninvasive positive-pressure ventilation, acute lung injury, and pneumonia were recorded. Repeated-measures analysis of variance assessed group, time, and group by-time interactions. <h3>Results</h3> Preoperative and intraoperative data were comparable. Proinflammatory cytokine leakage was reduced by LF. Group L showed shorter intubation time (median 9.5 hours versus group S, 15.0 hours; <i>p</i> = 0.0001), and intensive care unit length of stay (median 19.0 hours versus group S, 24.5; <i>p</i> = 0.0001), lower need for noninvasive positive-pressure ventilation (5 of 30, 16.7%, versus 12 of 30, 40%; <i>p</i> = 0.042). The AaDO₂, PaO₂/FiO₂, lung compliance, and radiographic lung injury score worsened early postoperatively, followed by progressive improvements (time <i>p</i> ≤ 0.001 for all). Such decline of AaDO₂, PaO₂/FiO₂, lung compliance, and radiographic lung injury score was significantly attenuated by LF (group by-time <i>p</i> = 0.0001 for AaDO₂, PaO₂/FiO₂, and lung compliance; <i>p</i> = 0.004 for radiographic lung injury score). <h3>Conclusions</h3> Arterial plus cardioplegic LF significantly reduced proinflammatory cytokine release after cardiopulmonary bypass, thus ameliorating postoperative indexes of lung function and overall respiratory outcome." @default.
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• W2027037358 date "2011-07-01" @default.
• W2027037358 modified "2023-10-12" @default.
• W2027037358 title "Leukocyte Filtration Ameliorates the Inflammatory Response in Patients With Mild to Moderate Lung Dysfunction" @default.
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• W2027037358 doi "https://doi.org/10.1016/j.athoracsur.2011.03.087" @default.
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