| Abstract
| - Platelet damage, complement activation and neutropenia duringcardiopulmonary bypass are the result of blood contact with artificialsurfaces, mainly in the oxygenator. To evaluate biocompatibility of thiskind of bypass we compared two techniques of extracorporeal circulation in40 patients undergoing elective coronary bypass operations. In 20, astandard technique with a bubble oxygenator was used (group 1), and in theremaining 20 patients with autooxygenation, the patients' own lungs wereincluded in the perfusion circuit (group 2). Several blood samples weretaken before, during and after perfusion to estimate the corrected plateletnumbers and pulmonary leucocyte sequestration in all patients, andadditionally in 6 patients from each group, complement C3a and C5aanaphylatoxins were measured (radioimmunoassay). At the end ofcardiopulmonary bypass, the decline of platelet number corrected tohaematocrit platelet number in group 1 was significantly higher than ingroup 2 (P less than 0.01). There was a significant increase in circulatingwhite blood cells when compared to pre-bypass time in both groups (P lessthan 0.05). However, comparison of differences between leucocyte counts inthe blood of the patients' right and left atria showed enhanced leucocytesequestration in group 1, 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x10(3)/mm3 in group 2. The C3a rose progressively during extracorporealcirculation: in group 1 from 268 +/- 46 ng/l to 521 +/- 65 ng/l, and ingroup 2 from 244 +/- 46 ng/l to 418 +/- 34 ng/l (P less than 0.05). Nocharacteristic changes in C5a activation were observed in eithergroup.(ABSTRACT TRUNCATED AT 250 WORDS)
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