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The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 1014-1019, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
W Riegel, G Spillner, V Schlosser and WH Horl
Plasma levels of granulocyte lactoferrin, myeloperoxidase, and elastase in
alpha 1-proteinase inhibitor complex were compared with C3a and C5a levels
in 10 patients undergoing cardiopulmonary bypass. At the end of the
operation, plasma levels of lactoferrin increased from 97.0 +/- 22.8 to
1257 +/- 139.8 ng/ml, myeloperoxidase increased from 37.1 +/- 4.3 to 170.9
+/- 34.9 ng/ml, and elastase in alpha-proteinase inhibitor complex rose
from 89.4 +/- 7.4 to 437.8 +/- 97.3 ng/ml. There was also a significant
anaphylatoxin formation. To investigate the relationship between complement
and granulocyte activation, patients undergoing cardiopulmonary bypass
received the calcium channel blocker nifedipine (orally and intravenously)
and the antiplatelet drug dipyridamole. The continuous infusion of
nifedipine (5.91 +/- 0.53 micrograms/kg body weight per hour) caused
significantly lower levels of elastase in alpha- proteinase inhibitor
complex and lactoferrin but not anaphylatoxin. Dipyridamole was without
effect on complement and granulocyte activation during cardiopulmonary
bypass. Our data demonstrate inhibition of granulocyte activation during
cardiopulmonary bypass by continuous infusion of nifedipine, even in the
presence of complement activation.
ARTICLES
Plasma levels of main granulocyte components during cardiopulmonary bypass
Department of Medicine, University of Freiburg, Federal Republic of Germany.
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