• Juha Koskenkari, Jussi Rimpiläinen, Fausto Biancari, Heljä-Marja Surcel, Päivi Kaukoranta, Kai Kiviluoma, Tero Ala-Kokko, and Tatu Juvonen.
• Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland. juha.koskenkari@fimnet.fi
• Scand. Cardiovasc. J. 2005 Dec 1;39(6):358-68.

BackgroundIschemia-reperfusion injury secondary to leukocyte activation has been widely recognized as one of the most relevant mechanism leading to postoperative organ dysfunction occurring after a period of ischemia. The aim of the present study was to evaluate in a prospective, randomized study, the value of leukocyte depleting filter in patients undergoing elective coronary artery bypass surgery.MethodsTwenty patients scheduled for elective on-pump coronary artery bypass surgery were randomized to undergo cardiopulmonary bypass either with a leukocyte depleting filter incorporated in the extracorporeal circulation arterial line or without a filter.ResultsThe main finding of this study was the significantly lower postoperative concentrations of cardiac troponin I in the leukocyte filter group (Tests of between-subjects effects: p = 0.024). There were also slightly better cardiac indices in the leukocyte filter group. A larger amount of blood units was infused intra- and postoperatively in patients undergoing cardiopulmonary bypass with leukocyte filtration (median, 600 [IQR, 0-1200] vs. 0 [IQR, 0-600], p = 0.08). Two patients in the leukocyte filter group underwent reoperation for bleeding but none in the control group (p = 0.48). Intra-and postoperative platelet count was lower in the leukocyte filter group (Tests of between-subjects effects: p = 0.08). Despite a significant increased concentration of C-reactive protein on the first postoperative day in the control group (p = 0.029), repeated-measures analysis failed to show any significant increase during the study period (p = 0.33).ConclusionsThe results of this study suggest a myocardial protective effect of leukocyte filter in the setting of elective coronary artery bypass surgery.

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