European Journal of Cardio-Thoracic Surgery, Vol 11, 162-168, Copyright © 1997 by European Association for Cardio-thoracic Surgery
Complement and neutrophil activation during cardiopulmonary bypass: a randomized comparison of hypothermic and normothermic circulation
M Chello, P Mastroroberto, R Romano, R Ascione, D Pantaleo and V De Amicis
Department of Cardiac Surgery, Medical School of Catanzaro, Italy.
OBJECTIVE: Activation of both complement and neutrophils has been
demonstrated to be involved in many pathological reactions following
cardiopulmonary bypass (CPB). The aim of the present study is to evaluate
the effect of normothermic and hypothermic CPB on both complement and
neutrophil activation. METHODS: Two groups of patients (n = 20 each)
scheduled for elective coronary artery bypass grafting, underwent CPB with
intermittent warm or cold blood cardioplegia. Plasma concentration of C3a,
C5a and C5b-9, as well as nitro-blu tetrazolium (NBT) scores of circulating
neutrophils were measured before anesthesia, 10 and 30 min after the
beginning of CPB, and 8, 16 and 24 h, postoperatively. RESULTS: In both
groups, CPB determined a significant complement activation, evidenced as a
significant increase in plasma concentration of C3a, C5a and C5b-9. This in
turn triggered the neutrophil activation, documented as a significant
increase of NTB scores in circulating neutrophils at the end of CPB and in
the early postoperative period. Interestingly, in the warm group the extent
of both complement and neutrophil activation was significantly higher
compared with the cold group during the whole sampling period. CONCLUSION:
In conclusion, our study clearly demonstrates that warm CPB is associated
with an increased ability to activate complement and neutrophils in
patients undergoing coronary surgery.
