Intraoperative hemocarboperfusion for correction of immune disorders associated with cardiac surgery with cardiopulmonary bypass
Vykhrystenka K.S., Smirnova A.U.
Vitebsk State Medical University, Vitebsk, Belarus
The aim of the work was to compare changes of immune system between patients, who undergoing hemocarboperfusion (HCP) during cardiopulmonary bypass and only CPB.
Material and methods. Study was performed by the protocol of open prospective study in parallel groups of patients, which included patients with heart disease requiring surgery using CPB. We examined 32 patients. Patients divided into groups: group 1 consisted of 16 patients, which undergoing HCP during CPB and group 2 - 16 patients who during CPB without HCP. We studied blood cell count, indicators lymphocyte phenotype and activation markers (CD4 +, CD4 + CD25 +, CD8 +, CD8 + CD25 +, CD25 +, CD19 +), adhesion molecules on leukocytes (αÌ(CD11b), αÕ(CD11c)), the levels of IL-1b, IL-2, IL-6, INF-γ, C3 and C4 complement components.
Results. Application of HCP during CPB causes a decrease number of lymphocytes CD4 +, CD8 +, CD25 + activated cells, adhesion molecules on leukocytes αÌ(CD11b), complement C3 component. Simultaneously, the patient has an adaptive component (B-lymphocytes) immunity.
The character of changes of cytokine profile in both groups indicates the development of systemic inflammatory response, but the level of IL-6 in the postoperative period was higher in the first group. The level of IL-2, IFN-γ in the first group was smaller than second group, what reduces the risk of SIRS.
Conclusion. HCP have a positive effect on the immune status of the cardiac surgical patients.