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The effects of cardiopulmonary bypass on immune mechanisms of man

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Immunological functions were evaluated in a group of six male patients undergoing elective cardiopulmonary bypass.

The investigations included differential white cell count, immunoglobulins IgG, IgM, and IgA, complement components C4 and C3, C-Reactive protein (CRP), neutrophil chemotaxis and neutrophil phagocytotic and microcidal capacities. All the studies were carried out pre-operatively, per-operatively and post-operatively, except neutrophil chemotaxis which was measured preoperatively and post-operatively only.

The results show that significant neutrophilia occurred post-operatively. The immunoglobulin levels dropped significantly per-operatively (P<0.001). The complement levels dropped per-operatively (C3-P<0.05, C4-P<0.05), CRP rose dramatically post-operatively (P< 0.001).

The neutrophil phagocytotic and microcardial remained normal and the neutrophil chemotactic studies revealed the presence of a serum inhibitor of chemotaxis present in the post-operative phase (P<0.05).

These results demonstrate that the effects of cardiopulmonary bypass on immune responses are balanced; the neutrophilia and normal neutrophil phagocytosis and microcidal capacities countered the inhibited chemotaxis and the fall in immunoglobulin and complement levels.

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Correspondence to J. P. Lavelle or J. P. Duignan or M. C. Neligan.

Additional information

We wish to express our sincere thanks to Mr. Robert Woods for his expert advice on the executions of the methods for this study, to Messrs. C. Dunne and W. Reardon for assistance with the studies, to Miss R. Devery and Mr. A. Joyce for assistance with the diagrams and to the Department of Photography in the Mater Misericordiae Hospital and in particular Mr. George Scully, to Miss L. Stone for typing this manuscript and finally we would like to thank the Medical Research Council of Ireland and the Mater Misericordiae Hospital for research grants to support this project.

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Lavelle, J.P., Duignan, J.P. & Neligan, M.C. The effects of cardiopulmonary bypass on immune mechanisms of man. I.J.M.S. 153, 431–436 (1984). https://doi.org/10.1007/BF02939834

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  • Cardiopulmonary Bypass
  • Pack Cell Volume
  • Full Blood Count
  • Neutrophil Chemotaxis
  • Mater Misericordiae Hospital