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Title: A clinical study of the effect of leucocyte depleting arterial line filtration on cerebral microemboli and neuropsychological outcome after coronary artery bypass surgery
Author: Whitaker, D. C.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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Objective: A randomised clinical trial sought evidence as to whether leucocyte depleting arterial line filters had any effect on intra-operative cerebral microemboli and post-operative neuropsychological outcome in patients undergoing elective coronary artery bypass (CABG) surgery. Methods: One hundred and ninety-two patients were randomised to the use of a Pall LG-6 leucocyte depleting (test) filter or either an Avecor Affinity or Pall AV-6 control filter. Cerebral microemboli during surgery were recorded by transcranial Doppler monitor over the right middle cerebral artery. Evidence of cerebral impairment was obtained by comparing patients’ performance in a neuropsychological test battery (9 tests) administered 6-8 weeks post-operatively with their pre-operative scores. Results: The groups proved well balanced in pre-operative variables. During cardiopulmonary bypass the median number and range of microemboli was 15 (3-180) in the leucocyte depleting group compared to 67 (5-846) and 55 (2-773) for the Avecor and AV6 groups respectively (p<0.0001). One hundred and sixty-one patients completed all the neuropsychological tests. The leucocyte depleting group showed better post-operative performance in all but one of the nine tests although the difference in a total change score did not reach significance (p = 0.07, 1 tailed t test). Conclusion: Leucocyte depleting filtration during CABG reduced the number of cerebral microemboli recorded by transcranial Doppler and showed a strong trend towards improving neuropsychological performance post-operatively. These findings suggest that the use of such filters in CABG surgery may offer increased neuroprotection.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available