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Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

Effect of temperature on leukocyte activation during cardiopulmonary bypass (CPB) and postoperative organ damage

Aim

To investigate the effect of core temperature (T°) during CPB on leukocyte activation and cytokine production and to correlate those findings to postoperative organ damage in an animal experimental model.

Methods

18 young pigs were randomly assigned to a T°- group during CPB: normothermia (T° 37°C; n = 6), mild hypothermia (T° 28°C; n = 6) and deep hypothermia (T° 20°C; n = 6). Leukocyte count and plasma levels of tumor necrosis factor (TNFα) were measured before, during and after CPB. At the end of the experimentation (6 h post-CPB), probes of heart, lungs, liver, kidney, and intestine were taken for histological examination.

Results

There was a significant fall of leukocyte count at induction of CPB, without any intergroup difference. During and at the end of CPB, leukocyte count was significantly higher in group 37°C as compared with the other groups. At a later stage after CPB, group 20°C showed significantly higher leukocyte count than group 28°C and group 37°C, respectively. The course of neutrophils was similar.

TNF-α was not released in group 28°C neither during nor after CPB. By contrast, there was a significant production of TNF-α in groups 37°C and 20°C, the circulating levels being significantly higher in group 37°C. Histological examination showed that the most important tissue damage in terms of interstitial edema and leukostasis in heart, lung, liver, kidney, and small intestine was seen in group 37°C followed by group 20°C while the least important damage was present in group 28°C.

Conclusion

CPB-induced postoperative organ damage, probably related to leukocyte activation and TNF-α production, is highest in pigs operated on in normothermia and lowest in those operated on in mild hypothermia.

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Qing, M., Seghaye, M., Vazquez-Jimenez, J. et al. Effect of temperature on leukocyte activation during cardiopulmonary bypass (CPB) and postoperative organ damage. Crit Care 3, P20 (1999). https://doi.org/10.1186/cc331

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Keywords

  • Tumor Necrosis Factor
  • Histological Examination
  • Cardiopulmonary Bypass
  • Leukocyte Count
  • Core Temperature