Systemic leukofiltration does not attenuate pulmonary injury after cardiopulmonary bypass

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Oliver WarrenThanos Athanasiou

Abstract

Pulmonary injury mediated by activated leukocytes is a recognized complication of cardiopulmonary bypass. The aim of this paper is to systematically analyze the effects of systemic leukofiltration within the cardiopulmonary bypass circuit on pulmonary injury and related clinical outcomes. We performed a systematic search to identify randomized controlled trials reporting on the effects of systemic leukofiltration on respiratory parameters. Random effect meta-analytical techniques were applied to identify differences in outcomes between the two groups. Sensitivity and subgroup analyses were undertaken to evaluate study heterogeneity. Incorporating 995 patients, 21 studies satisfied the inclusion criteria. Systemic leukofiltration significantly increased the PaO2/FiO2 ratio within 12 hours of bypass cessation, (weighted mean difference (WMD), 25.97; 95% confidence interval (CI), 3.41-48.53; p = 0.02) but this effect was lost by 24 hours (WMD, 12.98; 95% CI, -7.93-33.89; p = 0.22). Leukofiltration significantly reduced the duration of ventilatory support postoperatively (WMD, -2.11 hours; 95% CI, -0.65 to -3.58; p = 0.005), but had no impact on postoperative chest infection, intensive care length of stay or hospital length of stay...Continue Reading

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Citations

Dec 5, 2008·Journal of Cardiothoracic and Vascular Anesthesia·Oliver J WarrenThanos Athanasiou
Aug 2, 2013·The Cochrane Database of Systematic Reviews·Sally SpencerEspeed Khoshbin
Dec 4, 2012·Journal of Graduate Medical Education·Sarah BlissettShiphra Ginsburg
Oct 3, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alexander WahbaUNKNOWN EACTS/EACTA/EBCP Committee Reviewers

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