Publication

Intraoperative cell salvage during cardiac surgery is associated with reduced postoperative lung injury

Engels, G. E., van Klarenbosch, J., Gu, Y. J., van Oeveren, W. & de Vries, A. J., Mar-2016, In : Interactive Cardiovascular and Thoracic Surgery. 22, 3, p. 298-304 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

Copy link to clipboard

Documents

  • Intraoperative cell salvage during cardiac surgery is associated with reduced postoperative lung injury

    Final publisher's version, 321 KB, PDF document

DOI

OBJECTIVES: In addition to its blood-sparing effects, intraoperative cell salvage may reduce lung injury following cardiac surgery by removing cytokines, neutrophilic proteases and lipids that are present in cardiotomy suction blood. To test this hypothesis, we performed serial measurements of biomarkers of the integrity of the alveolar-capillary membrane, leucocyte activation and general inflammation. We assessed lung injury clinically by the duration of postoperative mechanical ventilation and the alveolar arterial oxygen gradient.

METHODS: Serial measurements of systemic plasma concentrations of interleukin-6 (IL-6), myeloperoxidase, elastase, surfactant protein D (SP-D), Clara cell 16 kD protein (CC16) and soluble receptor for advanced glycation endproducts (sRAGEs) were performed on blood samples from 195 patients who underwent cardiac surgery with the use of a cell salvage (CS) device (CS, n = 99) or without (CONTROL, n = 96).

RESULTS: Postoperative mechanical ventilation time was shorter in the CS group than in the CONTROL group [10 (8-15) vs 12 (9-18) h, respectively, P = 0.047]. The postoperative alveolar arterial oxygen gradient, however, was not different between groups. After surgery, the lung injury biomarkers CC16 and sRAGEs were lower in the CS group than in the CONTROL group. Biomarkers of systemic inflammation (IL-6, myeloperoxidase and elastase) were also lower in the CS group. Finally, mechanical ventilation time correlated with CC16 plasma concentrations.

CONCLUSIONS: The intraoperative use of a cell salvage device resulted in less lung injury in patients after cardiac surgery as assessed by lower concentrations of lung injury markers and shorter mechanical ventilation times.

Original languageEnglish
Pages (from-to)298-304
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume22
Issue number3
Publication statusPublished - Mar-2016

    Keywords

  • Lung, Extracorporeal circulation, CARDIOPULMONARY BYPASS, INFLAMMATORY RESPONSE, PROTEIN CC16, BLOOD, AUTOTRANSFUSION, EXPRESSION, SUCTION

ID: 41413714