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Abstract: Poster Presentations |

DIFFERENT HEART-LUNG MACHINE CONCEPTS INFLUENCE PLATELET AND MONOCYTE SURFACE-MARKER EXPRESSION DURING CORONARY ARTERY SURGERY FREE TO VIEW

Thomas Waldow, MD*; Gunter Schumann, MD; Volker Schmidt; Oliver Tiebel, MD; Gabriele Siegert, MD; Michael Knaut, MD; Klaus Matschke, MD
Author and Funding Information

Herzzentrum Dresden, Dresden, Germany


Chest


Chest. 2005;128(4_MeetingAbstracts):273S-c-274S. doi:10.1378/chest.128.4_MeetingAbstracts.273S-c
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Abstract

PURPOSE:  Function of various cellular blood components is altered under conditions of cardiopulmonary bypass (CPB) which can lead to activation of pro- and anticoagulant systems. In the present study, the effects of two different heart-lung-machine (HLM) concepts on the expression of surface markers on monocytes and platelets are compared.

METHODS:  In a prospective, randomized and single-blinded study sixty patients with elective coronary artery bypass surgery were recruited into three groups. A standard system (group 1) was compared with a modified HLM containing of a Deltastream pump, surface-modified tubing, and reduced priming volume (Optimized Mini-Circulation Cardiopulmonary Bypass System (OMCPB)) (group 2). In group 3 patients were operated on without extracorporeal circulation (OPCAB). Blood was collected at different time points before, during, and until 48 hours after surgical intervention. Platelets were incubated with either CD42b-FITC-/ CD62P-PE- or Factor Va-FITC-/ Tissue Factor-PE-labeled antibodies. EDTA-anticoagulated blood was incubated with CD11b-FITC- / CD18-PE- labelled antibodies. Samples were analysed applying flow cytometry.

RESULTS:  CD42b-expression decreased significantly at the end of the observation period in group 1 disclosing significant differences to groups 2 and 3. Platelet Factor Va-expression was significantly elevated in group 1 during bypass compared to groups 2 and 3. Tissue Factor- and CD62P-expression showed no significant differences between groups. CD11b-expression on neutrophiles and monocytes increased significantly under bypass and until 30 minutes after bypass in groups 1 and 2 compared to group 3 with higher values in group 1.

CONCLUSION:  Activation of Factor X through monocyte CD11b expression and Factor Va expression on platelet surfaces are synergistic conditions in thrombin generation under CPB. This procoagulant stimulus could be significantly reduced using OMCPB.

CLINICAL IMPLICATIONS:  Dysfunction of cellular blood components has a major influence on clinical outcome after use of CPB through parameters like blood loss, systemic inflammation and micro-clot formation. Use of an optimized HLM may influence some of these factors.

DISCLOSURE:  Thomas Waldow, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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