Complement activation during cardiopulmonary bypass. Comparison of bubble and membrane oxygenators

N. C. Cavarocchi, J. R. Pluth, Hartzell V Schaff, T. A. Orszulak, H. A. Homburger, E. Solis, M. P. Kaye, M. S. Clancy, J. Kolff, G. M. Deeb

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140 Scopus citations

Abstract

A prospective randomized trial involving 91 patients undergoing cardiopulmonary bypass compared the effects of bubble oxygenators (with and without methylprednisolone sodium succinate) and membrane oxygenators on complement activation and transpulmonary sequestration of leukocytes. Patients were divided as follows: Group I, 30 patients, bubble oxygenator, Group II, 31 patients, bubble oxygenator and methylprednisolone sodium succinate (30 mg/kg); Group III, 30 patients, membrane oxygenator. In Group I, C3a increased from 323 ± 171 ng/ml during cardiopulmonary bypass to 1,564 ± 785 ng/ml at 25 minutes after bypass (p < 0.0001). A significant decrease in C3a was found in Groups II and III compared to Group I (p < 0.0001). C5a did not change significantly during cardiopulmonary bypass in any group. Reestablishment of pulmonary circulation at the end of bypass produced significant transpulmonary leukocyte sequestration in Group I; the median cell difference was 1,700/μl. Transpulmonary sequestration was significant (p < 0.0001) less in Group II (median cell difference = 200/μl) and in Group III (median cell difference = 400/μl) than in Group I. We conclude that cardiopulmonary bypass with bubble oxygenator alone initiates significantly (p < 0.0001) more C3a activation and leukocytes sequestration than when methylprednisolone sodium succinate (30 mg/kg) is given 20 minutes before the start of cardiopulmonary bypass with a bubble oxygenator or when a silicone membrane oxygenator is used.

Original languageEnglish (US)
Pages (from-to)252-258
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume91
Issue number2
StatePublished - 1986

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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    Cavarocchi, N. C., Pluth, J. R., Schaff, H. V., Orszulak, T. A., Homburger, H. A., Solis, E., Kaye, M. P., Clancy, M. S., Kolff, J., & Deeb, G. M. (1986). Complement activation during cardiopulmonary bypass. Comparison of bubble and membrane oxygenators. Journal of Thoracic and Cardiovascular Surgery, 91(2), 252-258.