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Detrimental Effects of Cardiopulmonary Bypass in Cyanotic Infants: Preventing the Reoxygenation Injury  Bradley S. Allen, MD, Shaikh Rahman, MS, Michel.

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Presentation on theme: "Detrimental Effects of Cardiopulmonary Bypass in Cyanotic Infants: Preventing the Reoxygenation Injury  Bradley S. Allen, MD, Shaikh Rahman, MS, Michel."— Presentation transcript:

1 Detrimental Effects of Cardiopulmonary Bypass in Cyanotic Infants: Preventing the Reoxygenation Injury  Bradley S. Allen, MD, Shaikh Rahman, MS, Michel N. Ilbawi, MD, Michael Kronon, MD, Kirk S. Bolling, MD, Ari O. Halldorsson, MD, Harold Feinberg, PhD  The Annals of Thoracic Surgery  Volume 64, Issue 5, Pages (November 1997) DOI: /S (97) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Total white blood cell (WBC) count and (B) neutrophil count, with and without leukofiltration, before bypass, 5 and 30minutes after initiating bypass, and on arrival in the intensive care unit. Note that, in infants undergoing leukofiltration, the total white blood cell and neutrophil counts decrease much more abruptly after 5minutes of bypass and remain low 30minutes later. However, they have returned to the baseline value by the time the infants arrive in the intensive care unit (*p<0.05.). The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Antioxidant reserve capacity in acyanotic and cyanotic infants after reoxygenation using cardiopulmonary bypass without leukofiltration. Note that there is a marked loss of the antioxidant reserve capacity in cyanotic infants, indicating exposure to a large amount of oxygen free radicals during reoxygenation (see text for description). (p<0.05; MDA=malondialdehyde.). The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Antioxidant reserve capacity in cyanotic infants after reoxygenation with cardiopulmonary bypass using 100% oxygen, 21% oxygen, or white blood cell (WBC) filtration. Note that there is a substantial loss of the antioxidant reserve capacity in infants reoxygenated using 100% oxygen, indicating exposure to a large amount of oxygen free radicals. Although this injury is reduced by using 21% oxygen, there is still a substantial depletion of tissue antioxidants. Conversely, there is almost no change in the antioxidant reserve capacity in infants reoxygenated using leukocyte filtration (see text for description). (p<0.05; MDA=malondialdehyde.). The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Antioxidant reserve capacity in cyanotic infants reoxygenated using cardiopulmonary bypass with leukocyte filtration at either 100% or 21% oxygen. Note that, although leukocyte filtration results in only a small change in the antioxidant reserve capacity, the generation of oxygen radicals is lowest if white blood cell filtration is combined with 21% oxygen (see text for description). (p<0.05; MDA=malondialdehyde.). The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

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