Introduction: The influence of normovolaemic haemodilution (NH) on lymphocyte apoptosis (LA) is not clear. The aim of this study was to asses lymphocyte apoptosis intensity during CABG and NH.
Method: Twenty male patients aged 53 to 70 underwent CABG under general anaesthesia and extracorporeal circulation (ECC) with NH. A priming volume of 1800 mL was used for all patients. Patients were divided into two groups: A-patients weighing 75 kg or less and B- more than 75 kg or more. The degree of NH resulting from different body mass was confirmed by haematocrit (Hct). Lymphocyte esterase (EL) and mitochondrial transmembrane potential (MTP) were used as apoptosis markers. Flow cytometric method and reagents such as FDA (fluoroscein diacetate) and CMX-ROS (chloromethyl-X-rosamine) were used for EL (FDA) and MTP (CMX-ROS) measurement. The EL, MTP, Hct and lymphocyte count were noted at seven stages: 1. before anaesthesia; 2. during NH; 3. after surgery; 4. the evening after surgery; 5. the morning of the first postoperative day; 6. the evening of the first postoperative day and 7. the morning of the second postoperative day. The Wilcoxon and Mann-Whitney tests were used for statistical analysis.
Results: In all patients the statistically significant increases of LA were noted from stages 2 to 7. LA increased in stages 2, 3, 4, fell in stage 5 and increased again in stages 6, 7. The inter-groups comparison shows significant differences in stages 6 and 7. The number of lymphocytes decreases in stage 2, 5, 6, 7.
Discussion: There are only few studies describing phenomenon of LA during different kind of surgery . The cardiosurgical procedures are connected with NH. Our study shows that the LA is not only depended on surgical stress but on degree of NH as well.
1 Delogu G, Moretti S, Famularo G, et al. Mitochondrial perturbations and oxidant stress in lymphocytes from patients undergoing surgery and general anesthesia. Arch Surg